Anatomic Syndromes Flashcards
Function of orbitofrontal area:
Voluntary action
Decision making
Socially appropriate behavior
Symptoms of orbitofrontal syndrome:
Socially inappropriate behavior:
- Witzelsucht (joking addiction)
- Disinhibition
- Echopraxia
- Utilization behavior
What is utilization behavior?
Reaching out and using objects in the environment in an automatic manner
Reflexive picking up a cup and drinking out of it
Function of the dorsolateral frontal area:
Executive functions, working memory, and selective attention
Symptoms of convexity syndrome:
Poor attention, motor programming, and immediate recall
What test is good for evaluation of dorsolateral abnormalities?
Wisconsin Card Sorting Test
Mesial frontal cortex function:
Mediates motivated behavior, such as initiation of movement or speech
Symptoms of mesial frontal cortex syndrome (also known as anterior cingulate circuit syndrome)
Amotivation, apathy, and akinesis
B/l lesions - akinetic mutism
Patients can be incontinent and may only eat or drink when fed
What is the treatment for mesial frontal cortex syndrome?
Methylphenidate
Where is the lesion in a Broca’s aphasia?
Posterior inferior frontal gyrus
Where is the lesion in kluver-bucy syndrome?
Bilateral temporal lesions involving the amygdala
What the symptoms of kluver-bucy syndrome?
Hypermetamorphosis (urge to touch everything), compulsive eating, and hypersexuality
What is prosopagnosia/visual agnosia?
Failure to identify objects and faces by visual identification
What is the capgras delusion?
Variant of prosopagnosia in which the patient believes that a friend, spouse, or a close family member has been replaced by an impostor
Lesion in capgras delusion:
Fusiform gyrus; occipito-temporal cortex
Apperceptive prosopagnosia:
Impaired object recognition. They are unable to recognize faces. However, they may be able to recognize people based on non-face clues
Lesion in apperceptive prosopagnosia:
Right occipital-temporal area
Associative prosopagnosia:
Impaired object identification. Can copy images but can not identify an image.
Symptoms of associative prosopagnosia:
Right anterior temporal area, more often bilateral.
Lesion in Wernicke’s Aphasia:
Superior temporal gyrus
Agraphesthesia
Inability to recognize letters or numbers drawn by fingertip on the patient’s skin
Astereognosis
Inability to recognize an object by touch
Ideomotorapraxia
Impaired understanding of tool functions
Can name a hammer but not what it does
What is Gerstmann syndrome?
Agraphia, acalculia, finger agnosia, and left/right confusion
Lesion in Gerstmann syndrome?
Dominant inferior parietal lobe
Dominant angular and supramarginal gyrus of the parietal lobe
What is the triad of balint syndrome?
Optic ataxia: the inability to move the hand properly to perform voluntary tasks. Visually-guided hand movements are impaired.
Oculomotor apraxia: the inability to voluntarily fixate eyes to specific locations.
Simultagnosia: the inability to focus on multiple objects.
Lesion location in balint syndrome:
Bilateral parietal-occipital lobes
What could cause balint syndrome?
Watershed infarcts, multiple embolic strokes, or PRES
Anton syndrome:
Cortical blindness
The patient has true blindness, but they deny the presence of this blindness
Lesion in anton syndrome:
Bilateral posterior cerebral artery territory infarction
Achromatopsia
Colorblindness
Lesion in achromatopsia:
Inferior lip of the occipital lobe, often bilateral
Lesion to the thalamus
What is limbic lobe syndrome?
Bilateral lesions in the anterior cingulate can cause akinesis and mutism
Alexia without Agraphia
Inability to read, but with retained ability to write
Lesion in what location can cause alexia w/o agraphia:
Splenium of the corpus callosum and unilateral occipital lobe
What can cause alexia w/o agraphia?
Unilateral posterior cerebral artery stroke
Limb Kinetic Apraxia lesion location:
Anterior corpus callosum
What is limb kinetic apraxia?
Inability to perform tasks when asked
Benedikt syndrome
Tegmentum midbrain
CN III palsy (ipsi)
Ataxia, tremor, weakness (contra)
Claude syndrome
Tegmentum midbrain
CN III palsy (ipsi)
Ataxia, tremor, vertical gaze palsy (contra)
Dejerine syndrome
Medial medulla
CN XIII palsy (ipsi)
Hemiplegia, +/- position/vibration loss (contra)
Locked in syndrome
Central pons
B/l paralysis below neck
Marie-Foix syndrome
Rostral pons, AICA and basilar perforators
Contralateral hypoesthesia to pain and temp (spinothalamic)
Ipsi ataxia (MCP)
Contra hemiparesis (corticospinal)
Mollaret’s syndrome
Dentate nucleus, inferior olive, red nucleus
Palatal myoclonus
Millard-Gubler syndrome
Caudal medial pons
CN VI and VII palsy (ipsi)
Weakness (contra)
Nothnagle syndrome
Tectum midbrain
CN III palsy (ipsi)
Ataxia and vertical gaze palsy (contra)
Parinaud syndrome
Dorsal midbrain
Paralysis of upward gaze and accommodation
Wallenberg syndrome
Lateral Medulla
Ataxia, loss of pain and temp for face, weakness of soft pallet, larynx/pharynx, Horner’s (ipsi)
Loss of pain and temp for body (contra)
Weber syndrome
Medial midbrain
CN III palsy (ipsi)
Weakness
Vertical gaze palsy (contra)
