control term two (2) Flashcards
what would dementia affecting the frontal lobe present as?
abnormality in behaviour
- impaired judgement
- abstract reasoning
- strategic planning
- emotional restraint
- control of appetite + continence
what do dementias affecting the medial temporal lobe, hippocampus, amygdala + limbic systems present with?
disorders of memory + hallucination
what do dementias affecting the parietal lobe present as?
impairment of visuospatial skills + integration of sensory inputs
leading to:
- sensory agnosias
- apraxias
what do dementias affecting the temporal lobe present with?
- receptive dysphasia (can’t understand what they’re being told)
- automatisms (actions performed involuntarily or unconsciously)
name 8 differential diagnoses for dementia?
- depression
- hypothyroidism
- B12 deficiency
- iatrogenic (drugs)
- normal pressure hydrocephalus
- subdural haematoma
- encephalitis
- neurosyphilis (rare but do see it)
what types of drugs could have side effects which look like dementia? 4
- anti cholinergics
- sedatives
- narcotics
- H2 blockers (reduce stomach acid)
multiple meds
name 10 types of dementias
- alzeihmers
- lewy body dementia
- parkinsons disease
- frontotemporal dementia (a syndrome, lots of causes)
- huntingtons
- vascular dementia (treatment may slow down progression but won’t cure)
- progressive supranuclear palsy (PSP)
- corticobasal degeneration (CBD)
- normal pressure hydrocephalus (NPH)
- prion disease (eg CJD)
which lobes of the brain are normally most affected by alzeihmers?
parietal + temporal lobes
what is the drug valproate used for?
mainly used for the prevention of seizures
- epilepsy
- bipolar disorder
- to prevent migraine headaches
what three classic symptoms does normal pressure hydrocephalus present with?
- dementia (cognitive problems)
- gait disturbance (ataxia)
- urinary incontinence
what are the causes of normal pressure hydrocephalus?
50% are idiopathic
50% have a preceding cause, eg:
- subarachnoid haemorrhage
- meningitis
- trauma
- radiation-induced
symptoms are caused by expansion of the lateral ventricles
what is levitiracetam?
anti-epileptic drug
histilogically, what does CJD look like?
a sponge
- hence name: transmissable spongiform encephalopathy
describe the 4 general stages of dementia
stage 1 mild:
- changes in memory
- changes in personality
- changes in visuo-spatial abilities
stage 2 moderate:
- aphasia
- apraxia
- confusion
- agitation
- insomnia
stage 3 severe:
- resistiveness
- incontinence
- eating difficulties
- motor impairment
stage 4 terminal:
- bedfast
- mute
- dysphagia
- intercurrent infection
what macroscopic findings are seen in the brains of patients with alzheimers? 3
reduced brain weight: 900-1200 (norm:1200 - 1400)
atrophy of gyri + widening of sulci:
- frontal
- temporal
- parietal
- hippocampus
ventricular dilatation
what microscopic findings are seen in dementia with lewy bodies?
underlying mechanism involves the buildup of Lewy bodies, clumps of alpha-synuclein protein in neurons
what is vascular dementia?
what is it also known as?
a dementia caused by problems in the supply of blood to the brain, typically a series of minor strokes, leading to worsening cognitive decline that occurs step by step
multi-infarct dementia
name a type of frontal temporal dementia?
what microscopic changes are seen in the brain?
pick’s disease
accumulation of tau proteins in the neurons
these accumulate into silver-staining spherical aggregations known as pick bodies
what is a febrile seizure?
who normally gets them?
seizure associated with a high body temperature (fever) but without any serious underlying health issue.
They most commonly occur in children between the ages of 6 months and 5 years
what is the definition of epilepsy?
2 or more unprovoked non-febrile seizures
types of epilepsy:
- generalised?
- focal?
- idiopathic?
- symptomatic?
- cryptogenic?
generalised:
- whole brain affected from onset
focal:
- seizures begin in part of brain (normally temporal or frontal)
idiopathic: - cause unknown (but assume genetic) symptomatic: - cause identified (ie can see tumour/lesion on scan) cryptogenic - pathology suspected but not identified
what is a tonic clonic seizure?
tonic part:
- lasts only a few seconds
- all muscles get tense (if standing fall over)
- may make a load groan or similar
clonic part:
- muscles contract + relax very fast -> jerking movements, biting tongue, hypoxia, can get urinary or faecal incontinence etc
when come round:
- very confused + can get angry/irrational
- often get headaches + need to sleep
what are some causes of symptomatic epilepsy? 8
- birth injury (eg hypoxic brain injury)
- disorder of neural development
- brain infection (eg meningitis)
- brain trauma
- brain tumour
- cavernoma
- cerebovascular disease (eg stroke)
- brain degeneration (eg dementia)
what is a cavernoma?
cavernoma is a cluster of abnormal blood vessels, usually found in the brain and spinal cord
excised ones look like raspberries
can cause haemorrhage as well as seizures