Cognitive Neurology Flashcards
define cognition
the mental action of acquiring knowledge through thought, experience and senses
name the different domains of cognition
memory executive function eg decision making/problem solving language social function attention
dementia is defined as significant cognitive decline in at least _ cognitive demain
1
a viral encephalitis will affect what cognitive domains?
memory
behaviour change
language
a head injury will affect what cognitive domains?
attention
memory
executive dysfunction
what are the features of transient global amnesia
abrupt onset antegrade amnesia with preserved knowledge of self that lasts <24 hours
usually only happens once
who gets transient global amnesia?
> 50
what is anterograde amnesia?
loss of ability to create new memories after the event that caused the amnesia
what are the features of transient epileptic amnesia?
forgetful, repetitive questioning
very short lived (20-30mins)
recurrent
transient epileptic amnesia is associated with what problem?
temporal lobe seizures
patient completes complex tasks but has no memory of doing them….
transient epileptic amnesia
what infections can cause cognitive impairment?
HIV syphilis
metabolic causes of cognitive impairment?
thyroid
calcium
hyponatraemia
everyday forgetfulness impacting on functioning indicates…
functional cognitive impairment
presentation of functional cognitive impairment
fluctuating symptoms in a highly functioning person
symptoms can get better or worse unlike in dementia
what should be excluded in a patient with suspected functional cognitive impairment
mood disorder
dementia
most common human prion disease?
creutzfeldt-jakob disease (CJD)
what happens in prion disease?
neurodegenerative proteinopathy of the prion protein
most common type of CJD? what age does it present in
sporadic
60s
clinical features of sporadic CJD?
rapid onset dementia
neurological signs
myoclonus
death very quickly (4 months)
most likely cause of CJD in young people?
genetic
patients with functional cognitive impairment tend to have had very good memories before the onset of their symptoms T or F
T
Ix of prion disease?
MRI
LP
histopathological appearance of CJD
spongiform changes as a result of neuron loss
main pathology in dementia syndromes
neurodegenerative proteinopathy
early onset alzheimers is onset before age __
65
alzheimers shows degeneration of what parts of the brain?
medial hippocampus
parietal lobes later
night blindness and visuospatial disturbance in a patient with alzheimers indicates what kind of brain pathology
posterior cortical atrophy
a patient with posterior cortical atrophy would struggle with what part of the addenbrookes test?
drawing shapes
what is the most common form of progressive primary aphasia in alzheimers patients?
difficulty repeating sentences (logopenic aphasia)
“staccato speech” is common in what form of dementia?
fronto-temporal
Ix of alzheimers
MRI
SPE-CT
LP
CSF findings in alzheimers?
reduced amyloid
increased tau protein
Tx of alzheimers?
address vascular risk factors
acetylcholine agonists eg cholinesterase inhibitors
frontotemporal dementia is a/an ___ onset dementia
early
what are the early features of FT dementia?
early frontal features eg disinhibition, apathy, loss of empathy, behaviour issues
semantic aphasia (naming problems)
loss of insight
pick bodies are present in what dementia
FT
increased tau and normal amyloid on CSF indicates what dementia
FT
MRI of FT dementia presents with atrophy of the ____ lobes
frontotemporal
Tx of FT dementia?
trazadone
antipsychotics
vascular dementia is __ onset
late
Tx of vascular dementia?
vascular risk factors +/-
cholinesterase inhibitor
presence of extrapyramidal features is a sign of what dementia?
lewy body
parkinsons dementia is most similar in presentation to what dementia?
lewy body dementia
huntingtons presents with __ onset dementia
early
loss of caudate heads on MRI…
late huntingtons dementia
symptoms of huntingtons dementia
frontal problems from dysexecutive syndrome
slowed speed of processing
Tx of huntingtons dementia
mood stabilisers
chorea management
what dementia patients should be referred to old age psychiatry?
> 65
gradual onset
what dementia patients should be referred to neurology?
<65
any unusual features
name the components of a dementia blood screen
B12 TFTs syphilis HIV Ca genetics
