cognitive neurology Flashcards
what is dementia
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
what is the commonest cause of dementia
mixed pathology -> disease accumulates over time
what is delerium
acute confusion
what are the first brain areas affected in AD (3)
hippocampus and medial temporal gyrus
what kind of memory loss occurs with hippocampal/medial temporal gyrus
episodic memory loss, usually anterograde
what are functional cognitive disorders
cognitive difficulties with memory and thinking due to abnormal function of brain systems (rather than atrophy)
why should brain scans be performed in those suspected of dementia
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
what causes cells to die in NDDs
protein aggregation (and other theories e.g. superoxide)
3 higher cortical functions of the frontal lobe
- executive function
- emotional
- speech production
3 higher cortical functions of the temporal lobe
- non-verbal semantic knowledge;
- object representation;
- verbal semantic knowledge
(4. spatial awareness)
3 higher cortical fucntions of the parietal lobe
- working memory
- paraxis (planning in space)
- literacy skills
2 functions of the occipital lobe
- vision
- spatial awareness
if a pt presents w gait apraxia (“stuck to the floor”) what could be the underlying conditon (2)
- vascular dementia
- normal pressure hydrocephalus
what type of movement is seen in CJD
myoclonus
if a pt walks into a room and cant find a chair, what area is there likely to be a lesions
posterior cortical -> visuospatial difficulties
if a pt “doesn’t know what a chair is” what condition may they have
semantic dementia
if a pt can give a history then what cortical function is intact
episodic memory
what is optic ataxia
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
what is oculomotor apraxia
a neurological disorder that causes problems with voluntary horizontal eye movement -> difficulty
to test semantic memory, what can be asked?
ask which picture belongs to a certain group e.g. which is a marsupial, which is nautical
damage to what area is likely to result in semantic dementia
L temporal lobe (if right handed)
what is semantic memory
conscious long-term memory for meaning, understanding, and conceptual facts about the world
what are the braak stages
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
