Delirium, Dementia, and Amnestic and Other Cognitive Disorders and Mental Disorders Due to a General Medical Condition

Question 1

Frontal lobe pathology clinical syndromes

Answer 1

1. Disinhibited, overfamiliar, tactless, garrulous, fatuous jokes and puns (Witzelsucht), errors of judgement and sexual indiscretions, disregard feelings of others.
2. Inert (abulic), apathetic, paucity of spontaneous speech, movement and emotional expressions
3. Obsessive, ritualistic behaviours with perseveration of thought and gesture

Intelligence usually unaffected
Difficulties in abstract reasoning, concentration and attention reduced, insight impaired. Verbal fluency reduced.
Difficult task switching, utilisation behaviour may occur
If exted to posterior dominant- brocasMotor cortex- hemiparesis,
ipsilateral optic atrophy or anosmia, grasp/primitive reflexes
If bilateral or midline, incontinence

Question 2

Parietal lobe clinical syndrome

Answer 2

Non-dominant- visospatial, neglect, constructional and dressing apraxia.

Domiannt- receptive dysphasia, limb apraxia, body image, R-L disorientation, dyscalculia, finger agnosia, agraphia

CL sensory loss, astereognosis, agraphasthesia, CL hemiparesis, homonymous inferior quadrantonopia

Anosognosia not uncommon (unware of deficit)

Question 3

Temporal lobe syndromes

Answer 3

Unilateral MTL-> lateralising memory deficits. L hippocampal= verbal memory (and semantic and fluent dysphasia). Psychotic sx.
R hippocampal affects non verbal (spatial) aspects of memory. Affective sx.