cognitive neurology

Question 1

what is dementia

Answer 1

a syndrome arising due to disease of the brain in which there is disturbance of higher cortical function (memory, thinking, orientation etc.) in multiple cognitive domains and consciousness is not clouded

Question 2

what is the commonest cause of dementia

Answer 2

mixed pathology -> disease accumulates over time

Question 3

what is delerium

Answer 3

acute confusion

Question 4

what are the first brain areas affected in AD (3)

Answer 4

hippocampus and medial temporal gyrus

Question 5

what kind of memory loss occurs with hippocampal/medial temporal gyrus

Answer 5

episodic memory loss, usually anterograde

Question 6

what are functional cognitive disorders

Answer 6

cognitive difficulties with memory and thinking due to abnormal function of brain systems (rather than atrophy)

Question 7

why should brain scans be performed in those suspected of dementia

Answer 7

scans are often normal in early stages but are useful in ruling out other causes, in refining the diagnosis and in finding out exacerbating/reversible factors

Question 8

what causes cells to die in NDDs

Answer 8

protein aggregation (and other theories e.g. superoxide)

Question 9

3 higher cortical functions of the frontal lobe

Answer 9

1. executive function
2. emotional
3. speech production

Question 10

3 higher cortical functions of the temporal lobe

Answer 10

1. non-verbal semantic knowledge;
2. object representation;
3. verbal semantic knowledge
   (4. spatial awareness)

Question 11

3 higher cortical fucntions of the parietal lobe

Answer 11

1. working memory
2. paraxis (planning in space)
3. literacy skills

Question 12

2 functions of the occipital lobe

Answer 12

1. vision
2. spatial awareness

Question 13

if a pt presents w gait apraxia (“stuck to the floor”) what could be the underlying conditon (2)

Answer 13

1. vascular dementia
2. normal pressure hydrocephalus

Question 14

what type of movement is seen in CJD

Answer 14

myoclonus

Question 15

if a pt walks into a room and cant find a chair, what area is there likely to be a lesions

Answer 15

posterior cortical -> visuospatial difficulties

Question 16

if a pt “doesn’t know what a chair is” what condition may they have

Answer 16

semantic dementia

Question 17

if a pt can give a history then what cortical function is intact

Answer 17

episodic memory

Question 18

what is optic ataxia

Answer 18

optical ataxia - the inability to accurately point to or reach for objects under visual guidance with intact ability when directed by sound or touch despite normal strength

Question 19

what is oculomotor apraxia

Answer 19

a neurological disorder that causes problems with voluntary horizontal eye movement -> difficulty

Question 20

to test semantic memory, what can be asked?

Answer 20

ask which picture belongs to a certain group e.g. which is a marsupial, which is nautical

Question 21

damage to what area is likely to result in semantic dementia

Answer 21

L temporal lobe (if right handed)

Question 22

what is semantic memory

Answer 22

conscious long-term memory for meaning, understanding, and conceptual facts about the world

Question 23

what are the braak stages

Answer 23

classify the level of disease in AD (and PD):
Braak stages I and II - NFTs confined mainly to the entorhinal region of the brain;
Braak stages III and IV -involvement of limbic regions such as the hippocampus;
Braak stages V and VI - moderate to severe neocortical involvement