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Nervous System > 15) Dementia and Epilepsy > Flashcards

15) Dementia and Epilepsy Flashcards

1
Q

What is dementia?

A

Progressive decline in higher cortical function leading to global impairment of memory, intellect and personality which affects activities of daily living

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2
Q

What are some types of dementia?

A

Alzheimer’s, fronto-temporal, vascular, dementia with Lewy Bodies

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3
Q

What are some reversible causes of dementia?

A 
Depression
Trauma
Vitamin def.
Alcohol
Thyroid disorders
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4
Q

What affect does dementia have on memory?

A

Struggle to learn new information

Short term memory loss

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5
Q

What are some behavioural features of dementia?

A

Altered personality, disinhibition, wandering

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6
Q

What are some physical signs in dementia?

A

Incontinence, difficulty swallowing

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7
Q

What investigations can be performed to diagnose dementia?

A

History and mini-mental state exam
Neurological exam
Blood tests for reversible causes: TFTs, B12
CT/MRI - rule out dementia

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8
Q

What is delirium?

A

Acute confusional state causing decline in mental function

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9
Q

What are the points on the conduction assessment method?

A

Acute change of fluctuating mental state
Altered consciousness
Inattention
Disorganised thinking

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10
Q

What might be seen on CT and MRI imaging of someone with dementia?

A

Dilation of ventricles, generalised atrophy, hippocampal atrophy

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11
Q

Describe the cognitive decline in Alzheimer’s disease, vascular and Lewy Body dementia:

A

Alzheimer’s: constant
Vascular: sudden drops
LB: varying

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12
Q

What is pathophysiology behind Alzheimer’s?

A

Loss of cortical and subcortical white matter causing gyral atrophy and ventricular dilation - due to amyloid beta plaques and neurofibrillary tangles

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13
Q

Describe the mild stage of Alzheimer’s:

A

2-4 years, minor memory loss

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14
Q

Describe the moderate stage of Alzheimer’s:

A

2-10 years, confusion, difficulty in self care, behavioural changes

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15
Q

Describe the severe stage of Alzheimer’s:

A

1-3 years, completely incapacitated, retreat into themselves, don’t recognise people, loss of bodily function, violence

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16
Q

Describe the pathophysiology behind Lewy body dementia:

A

Lewy bodies form in cortex and substiantia nigra causing degeneration

17
Q

What are the features of Lewy body dementia?

A

Fluctuations in cognitive impairment, Parkinsonism, visual hallucinations, REM sleep behaviour disorder, falls

18
Q

What can be the underlying cause of vascular dementia?

A

Atherosclerosis of BVs supplying brain

Diffuse small vessel disease infarcts

19
Q

What are some types of frontotemporal dementia?

A

Frontotemporal lobar degeneration with Tau pathology, Pick’s disease, familial tauopathies

20
Q

What are some of the features of frontotemporal dementia?

A 
Alteration of social behaviour and personality
Agitation 
Depression
Impaired judgement and insight
Mutism
21
Q

How should dementia be managed?

A

Drugs: cholinesterase inhibitors, memantine
Social care
Memory aids
Therapies - pets, babies

22
Q

What is a seizure?

A

Sudden, irregular discharge or electrical activity in the brain causing a physical manifestation

23
Q

What is a convulsion?

A

Uncontrolled shaking movements, rapid, repeated contraction and relaxation

24
Q

What is an aura?

A

Perceptual disturbance prior to seizure

25
Q

What is epilepsy?

A

Neurological disorder marked by sudden recurrent episodes of sensory disturbance, LOC or convulsions

26
Q

What is status epilepticus?

A

Epileptic seizures occurring continuously without recovery of consciousness in between

27
Q

How can seizures be classified?

A

Partial and generalised

28
Q

What are some examples of partial seizures?

A

Simple: same consciousness
Complex: consciousness impaired

29
Q

Give examples, with a brief description, of generalised seizures:

A 
Tonic-clonic: 1st muscles tense, 2nd convulsions
Absence: 'day-dreaming', sudden LOC
Myoclonic: brief shock like muscle jerks
Atonic: drop attack, fall to floor
Tonic: increased tone
30
Q

What investigations can be done on someone presenting after a seizure?

A

History, EEG, MRI

31
Q

Describe the key points to ask on a history of someone presenting with a seizure:

A

Prior to seizure (trigger, aura)
During (description, duration)
After (post ictal state)

32
Q

What are some differential diagnoses for seizures?

A

Stroke, meningitis, SLE, hypoxia, electrolyte imbalance, hypoglycemia, alcohol withdrawal

Nervous System (18 decks)

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