Behavioral Neurology Flashcards
Synucleinopathies
PD, MSA, DLB
Alpha-synuclein aggregate in cytoplasmin of neurons - found in what disorder?
= Lewy bodies
DLB
Tau-positive astrocytes - found in what disorder?
= “tufted astrocytes”
PSP
PSP findings on MRI
midbrain atrophy
“Hummingbird sign” / “Mickey Mouse sign”
Clinical findings in PSP
parkinsonism, falls, supranuclear gaze palsy
Clinical findings in MSA
parkinsonism, ataxia, autonomic dysfunction
MSA findings on MRI
atrophy of cerebellum, pons, inferior olives
“hot cross bun sign” / “putaminal rim sign”
Clinical findings in CBD
parkinsonism, apraxia, aphasia, alien hand syndrome
Ballooned neurons - found in what disorder?
CBD, Pick’s
Clinical findings in DLB
parkinsonism, dementia (cognitive fluctuations), autonomic dysfunction, visual hallucinations
Neurofibrillary tangles - found in what disorder?
AD
Tauopathies
AD, PSP, FTD, CBD, CTE, Parkinson-Dementia Complex of Guam
Define “aphemia”
Where is the lesion that leads to this?
Problem with speech production (ability to write is preserved)
Small lesion in Broca’s area
*ability to write sets aphemia apart from aphasias
Where is the lesion that causes Broca’s aphasia?
Posterior part of the dominant inferior frontal gyrus
Brodmann’s areas 44 and 45
Where is the lesion that causes Wernicke’s aphasia?
Posterior part of the dominant superior temporal gyrus
Brodmann’s area 22
What clinical abnormality is seen in conduction aphasia?
Where is the lesion that leads to this?
Impaired repetition (naming, writing) (speech is fluent, patients can comprehend the spoken word)
Arcuate fasciculus (fibers connecting Broca’s and Wernicke’s areas)
Where is the lesion that causes:
Transcortical Motor Aphasia
Transcortical Sensory Aphasia
Dominant supplementary motor area (SMA)
*watershed territory ACA-MCA
Dominant junction of temporal, parietal, and occipital lobes
*watershed territory MCA-PCA
What distinguishes transcortical aphasias from other aphasias?
Preserved repetition
Transcortical Motor Aphasia (expressive, like Broca’s)
Transcortical Sensory Aphasia (receptive, like Wernicke’s)
Match the genetic defect with the chromosome: Amyloid precursor protein (APP) ApoE Presenilin 1 Presenilin 2 Superoxide dismutase (SOD1)
1
14
19
21
APP - 21 ApoE - 19 Presenilin 1 - 14 Presenilin 2 - 1 SOD1 - 21
Abundant Hirano bodies - found in what disorder?
AD
Hirano bodies = eosinophilic inclusions found in cytoplasm of hippocampal neurons
Loss of neurons in which area of the brain cause decreased acetylcholine and choline acetyltransferase seen in AD?
Nucleus basalis of Meynert
CBD findings on MRI
Asymmetric parietal lobe atrophy
