Neurpsychiatric Conditions Flashcards
(29 cards)
Key symptoms of Stroke
- sudden severe headache with no known cause
- sudden trouble seeing in one or both eyes [pupil reactivity >4milimeter abnormal] / cortical blindness caused by occipital lobe damage and not eyes themselves
- sudden numbness or weakness of face, arm, leg lateralised
- sudden confusion , trouble speaking , difficulty understanding
- sudden dizziness , loss of balance or coordination (delirium)
What are the key factors to make an epilepsy diagnosis
1) at least 2 unprovoked seizures occurring more than 24h apart
2) one unprovoked seizure and reoccurrence risk of min 60% for further seizures (over next 10 years)
3) diagnosis clinically supported by EEG and positive signs
Recovery rates in ABI
3 months 50%
6 months 25%
12 months 12,5%
What are the steps diagnosing ABI
1) Are we dealing with open or closed TBI?
2) Acute/subacute (e.g anoxic brain injury )
3) Repetitive Injuries? (e.g chronic traumatic encephalopathy)
Huntingtons Gene Mutation?
Htt gene on short arm of chromosome 4> CAG repeat
Symptoms of Huntingtons
- Chorea
- bradykinesia
- tremor
- dystonia
- change in mood or behaviour
- change in cognition (thinking and memory)
Stages of huntingtons:
- Presymptomatic (genetic test positive)
- Prodromal phase (signs without symptoms )
- Chorea Manifestations of motor signs and symptoms over 20yrs
Symptoms of Parkinson
- Motor: shaking, stiffness, slowness, poverty of movement (tremor, rigidity on passive movement, slowness of movement, bradykinesia)
- Non motor: neuropsychiatric and cognitive disorders, drug-induced hallucinations, sensory disturbances, urinary disorders , sleep disorders, automatic dysfunctions, fatigue, sexual dysfunction
Lewy body dementia features
1) Dementia onset > 2) Start of Parkinsonism > 3) Start of visual hallucinations
What is Depersonalisation|Derealisation disorder
Disconnection from reality or detachment from oneself with intact awareness
Define Intellectual Disability
- Sig. impairment in intellectual functioning (<70 IQ)
- Sig. impairment in adaptive behaviour (2SD below mean on test of adaptive behaviour)
- Evidence of 1 and 2 in the development period (<18yrs)
Define MS
Inflammatory demyelinating disease with relapse-remitting characteristic periods
What increases the risk for MS to 99.5%
Ebstein-Barr Virus
Symptoms of MS
- Spasticity
- Cognitive loss
- Cortical (loss of functions)/subcortical dementia (slowing, apathy, depression, difficulty accessing function-cues)
- visual, sensory impairment
- bowel and bladder
- limb weakness
- incoordination
Type of Encephalitis causes
- Infective (e.g HIV)
- Autoimmune (NMDAR)
- Unknown (encephalitis lathargia)
Symptoms of Encephalitis (Acute vs Progressive)
Acute: sleep disturbances, movement disorder (catatonia, dyskinesia), seizures, autonomic dysfunctions, coma
Progressive: anxiety, agitation, psychosis/delusions, paranoia, hallucinations, catatonia/echolalia
Autism in DSM V
1) persistent deficits and ability to initiate and sustain reciprocal social interaction and social communication
2) restricted, repetitive and inflexible patterns of behaviour, interest, activities including the differences in sensory sensitivities and interest
Neurological diagnostic features of FND
- disorder of volition = harder when trying to
- observe positive signs (conscious and unconscious) like hoovers sign, give way weakness
- examine strength, balance, vision
- previous medical history explained or unexplained
- childhood trauma
- past psychiatric history
- predisposing, precipitating and maintaining factors
Diagnostic criteria for Tourette’s
- multiple motor and one or more vocal tics have been present (not necessarily concurrently)
- tics may wax and wane in frequency but persist over 1 year
- onset before 18 years
Clinical Presentation of HIV encephalopathy
- confusional state, memory difficulties, concentration problems, decreased drive, mood changes, mental slowing,
+ Behavioural changes: apathy, social withdrawal, agitation, anxiety, irritability, emotional lability, psychosis-like features (delusions, hallucinations)
+ Motor dysfunctions: poor balance, deterioration of handwriting, weakness of limbs
Clinical features of progressive Multifocal Leukoencephalopathy
- progressive dementia
- neurological deficits
- paresis
- ataxia (lack of coordination)
- dysphasia
How does abnormal striatal dopamine give rise to psychotic symptoms?
- We learn an update beliefs through prediction errors > constant prediction of expected happening in our environment
- When surprise occurs dopamine neurons fire > facilitating learning from experience so that event remembered with enhanced value
- schizophrenia shows increased striatal dopamine and prediction error abnormality > increase signaling leads to aberrant assignment of importance (salience) to an important stimul
- Excessive dopamine activity destructs normal sensory processing and perception leading to perception distortion > sensory experience not based on external stimuli (own thoughts or background noice interpreted as external voices)
Typical Symptoms after mild TBI (early, progressive, late)
Early: double vision, blurred vision, nausea , dizziness, tinnitus , drowsiness
Progressive: insomnia, headache, memory, fatigue, poor concentration, noise & light sensitive
Late: irritability, anxiety, depression
Criteria for MS diagnosis
Following McDonald criteria:
- time: more than 1 attack
- space lesions in more than one area (inflammatory lesions, gadolinium enhancing lesions)
- T1 black holes and atrophy
- independent immune attack in CNS
- exclude mimics
