Behavioral Neurology Flashcards
What is aphemia, and what is the lesion?
inability to speak, but can write. (not language per say).
caused by small Broca’s lesion or subcortical white matter.
dominant inferior frontal gyrus problem causes what?
Broca’s aphasia: nonfluent speech, can’t name, can’t repeat, can’t write. CAN comprehend.
dominant superior temporal gyrus problem?
Wernicke’s aphasia: severe comprehension problem with fluent nonsensical speech.
conduction aphasia?
fluent speech, comprehension okay but cannot name, write, repeat. Prob w/ arcuate fasiculus connecting broca and wernicke areas.
Hallmark of transcortical aphasias?
CAN repeat. (May be sensory or motor with similar as either broca’s or wernickes but with preserved repetition.)
Location of transcortical motor aphasia?
dominant supplementary motor area, connection of SMA to broca, or above/anterior to Broca.
location of transcortical sensory?
junction or temporal, parietal, occipital lobes.
What is Balint syndrome?
disconnection with ocular apraxia, optic ataxia, simultagnosia, depth problems
what causes balint syndrome? location
damage to bilateral parieto-occipital region: can’t see where something is, but can do what it is (occipitoparietal vs occipitotemporal)
pure word deafness or auditory verbal agnosia
hear sounds but can’t understand words or repeat. They can read/write.
what causes pure word deafness?
deep dominant superior temporal lesion or bilateral lesions of midsuperior temporal gyrus
Alien limb syndrome?
involuntary movement of limb, feel like no control of hand
three causes of alien hand?
- corticobasilar degeneration
- corpus callosum lesion
- ACA infarct
Anton syndrome? what causes it?
cortical blindness but deny it, caused by bilateral occipital lobe damage
Do anton patients blink to threat or have optokinetic responses?
No
Do anton patients have pupil response to lt?
Yes.
Capgras syndrome?
delusion that people around them have been replaced by impostures. (people captured)
Charles Bonnet’s syndrome?
vision loss with people seeing things in space where vision was lost.
Ganser syndrome
approximate answers: Dance around the question
Gerstmann syndrome? 4 things? Where is lesion?
- finger agnosia
- R/L confusion (need AAA b/c lost)
- acalculia
- agraphia
(AAAAA: Dominant Angular gyrus)
location of lesion in Gerstmann syndrome?
angular gyrus dominant parietal lobe (remember all the As on the fingers: agraph, acalc, agnos, AAA b/c can’t tell L/R, angular gyrus)
what causes akinetic mutism?
silent and still due to bilateral medial frontal damage (cingulate)
what is anosodiaphoria?
lack of concern about their impairment (don’t sweat the big stuff: diaphoretic)
anosognosia is what and in what location is the lesion?
unaware of impairment
right parietal lesion
what is catalepsy?
patient remains in position they are placed.
cataplexy?
in narcolepsy with sudden loss of tone following emotions
Two types of catatonia?
stuporous: mute, immobile, echolalia/praxia, posturing.
excited: purposeless frenetic activity
what is ideational apraxia?
can perform individual component of sequence, but not the whole thing. (can perform each idea, but not summation)
ideomotor apraxia?
can perform movement but not on command (Can do the motor, but not if someone else’s idea)
what is logorrhea?
pressured, abundant speech (diarrhea of mouth/words)
Borderline ID?
70-85
mild ID
50-70
moderate ID
30,40,50
severe ID
20-40
profound ID
< 25
Wisconsin card sort test is good for what testing
executive function / frontal lobe
What is witzelsucht?
inappropriate laughter, orbitofrontal lesions
Disinhibited syndrome
orbitofrontal syndrome
function of orbitofrontal prefrontal cortex
integrates emotional info and self awareness into appropriate behaviors
what is environmental dependency / utilization behavior
can’t inhibit environmental reactions like seeing coffee cup and drinking it
dysexecutive syndrome
dorsolateral syndrome of prefrontal cortex for working memory and executive functioning
medial/anterior cingulate frontal lobe syndrome
abulia, apathy syndrome
what lesion can lead to akinetic mutism in most severe form
cingulate gyrus, b/l medial frontal
what is anasognosia
lack of awareness of deficit in right parietal lesions
it aint so: anasognosia
anosodiaphoria
lack of concern about ones impairment (diaphoria: don’t sweat small stuff)
catalepsy vs cataplexy
catalepsy is waxy flexibility
cataplexy is sudden loss of tone w/ narcolepsy (lepsy and lepsy dont go together)
area involved in alternating shyness/fearfulness and fits of unprovoked rage
amygdala
what are the main features of Kluver Bucy syndrome and where are the lesions
placidity (docility), hyperphagia/orality, hypersexuality, visual agnosia
bilateral anterior (amygdala) temporal lobe lesion
epilepsy syndrome w/ hypergraphia and micrographia, deepened intellectual life, hyperverbality
TLE
purposeless frenetic activity
excited catatonia
features of memory with b/l hippocampal damage
severe anterograde (learning), moderate retrograde, intact registration and implicit memory
Papez circuit
Hippocampus via fornix to MACE:
Mammillary body, Anterior Nucleus thal, Cingulate, Entorhinal cortex
repetition requires what 3 structures intact
Broca
Wernicke
Arcuate Fasciculus that connects them
watershed infarcts may lead to what aphasia problem / feature
transcortical: can repeat
Percentage of left handed people with left language brain
60-70%
Area involved in agraphia
Exner’s writing area: motor programs for writing that feed into Brocas
what causes alexia without agraphia?
PCA stroke in left hemisphere that involves the posterior / splenium of the corpus callosum such that visual info from right still can’t cross over
what is simultagnosia and what is it seen in?
can’t put the whole picture / image together to make full sense of it
seen in Balints
‘in anton syndrome what exam features?
no blink to threat and no OKN, but pt doesn’t think there is a problem or realize they are blind
Dorsal vs Ventral visual pathways
dorsal: Where
Ventral: What
Charles bonnet syndrome:
seeing things in space where vision was lost
where is the lesion with agnosia?
dominant inferior temporal occipital cortex (can’t get the what)
recognition issue?
agnosia?
what side is neglected in hemineglect and why
left neglect b/c due to nondominant lesions typically
ideational apraxia is what
inability to plan a motor sequence
three lesions that can cause alien limb
- corpus callosum
- ACA infarct
- corticobasal ganglionic degeneration
lesions for prosopagnosia
b/l inferior occipital/temporal lesion
What is Witzelsucht?
inappropriate laughter: orbitofrontal lesion
