Neuro 6 Flashcards
Define apraxia and what part of the brain causes it
o Inability to carry out a learned motor task despite preservation of the primary functions need to carry out the task, such as comprehension, motor ability, sensation, and coordination
o Caused by lesions in the frontal or parietal lobes of the dominant hemisphere – cortical lesion
Describe agnosia and what part of the brain causes it
o Inability to recognize objects despite preservation of the basic sensory modalities being used
o Caused by lesions in the sensory associated areas of the brain – processing areas that lie next to the primary sensory areas – cortical lesion
4 components of Gerstmann syndrome
♣ 1. Agraphia (inability to write)
♣ 2. Acalculia (inability to calculate)
♣ 3. Finger agnosia (inability to distinguish fingers)
♣ 4. Left-right disorientation
Part of the brain affected in Gerstmann syndrome
o Damage to dominant parietal cortex
Part of the brain affected in hemispatial neglect
o Damage to non-dominant frontal or parietal cortex (usually R-sided)
o Will cause neglect to contralateral (L) side
Describe tests that should be done in a patient with dementia
♣ Hematologic screening including ESR
♣ Vitamin B12 and Folate
♣ Calcium
♣ LFTs, including ammonia
♣ Electrolytes
♣ Serum urea nitrogen and creatinine levels
♣ Infection workup: Syphilis, HIV, TB, etc.
♣ Thyroid function tests
♣ EEG – look for seizuers
♣ CT or MRI – structural abnormalities (tumor, hematoma, hydrocephalus)
♣ Brain biopsy – CJD, HIV, CNS vasculitis
Presentation of Lewy body dementia
Early onset dementia with visual hallucinations followed by Parkinsonian features
Clinical findings of Progressive Supranuclear Palsy (PSP)
- Supranuclear ocular palsy (failure of vertical gaze), dysarthria, dysphagia, extrapyramidal rigidity, gait ataxia, dementia
- Earliest signs are falls and gait abnormality
Which parts of the brain are affected by PSP
• Atrophy of dorsal midbrain, globus pallidus, and subthalamic nucleus
o Hummingbird sign
Presentation of Huntingtons
Chorea, dementia, personality and behavioral changes
Part of the brain affected in Huntingtons
Caudate and putamen
Presentation of frontotemporal dementia
- Early = Behavior/personality changes (frontal lobe) and/or aphasia (temporal lobe)
- Late = Dementia
Presentation of CJD
• Rapidly progressive dementia + ataxia + startle myoclonus
What will be seen on EED in CJD
• Periodic sharp waves on EEG
What will be seen in CSF in CJD
Presence of protein 14-3-3
Ddx for neurological causes of facial pain
Trigeminal neuralgia
Postherpetic neuralgia
Giant cell arteritis
Cluster HA
Definition of dystonia
Sustained muscle contraction (e.g. torticollis)
What is hemiballismus and what part of the brain is it caused by
Unilateral violent arm flinging
Caused by damage to the contralateral subthalamic nucleus
Where do hypertensive hemorrhages usually occur in the brain
Lacunar stroke = basal ganglia, cerebellum, thalamus, pons
Presentation of myasthenic crisis
- Increased generalized and oropharyngeal weakness
* Respiratory insufficiency/dyspnea
Tx of myasthenic crisis
- Intubation for deteriorating respiratory status
* Plasmaphoresis or IVIC and corticosteroids
Presentation of Wilson disease
♣ Copper accumulation leads to:
• Kayser-Fleisher rings copper deposition in the cornea
• Liver disease
• Neurologic manifestations (behavioral changes, dementia, chorea, parkinsonian symptoms)
Diagnosis of Wilson disease
- Low ceruloplasmin
* Increased urinary copper excretion
Describe EEG features of sleep cycle
BATS Dream Big
Awake (eyes open) = beta Awake (eyes closed) = alpha N1 = theta N2 = K spindle fibers N3 = delta REM = beta
