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Neuro > Dementia, seizures and blood supply > Flashcards

Dementia, seizures and blood supply Flashcards

1
Q

Presentation of dementia

A

Memory loss
Altered personality
Disinhibition
Incontinence
Anomic aphasia (difficulty word-finding)
Apraxia (difficulty performing learned purposeful movements)
Can’t identify visuospatial relationships

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2
Q

Investigations for dementia

A 
Collateral history
Mini mental state exam
CAM score
Neurological exam
Blood test for organic causes e.g TFTs and vitamin B12
Memory clinic 
Head CT/MRI to rule out SOL
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3
Q

Criteria for confusion assessment method

A

Acute
Inattention (can’t count back from 20)
Decreased consciousness
Disorganised thinking

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4
Q

Pattern of cognitive decline in each type of dementia

A

AD: linear
Vascular: stepwise relating to vascular accident
Lewy body: fluctuates but general decline

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5
Q

Describe Lewy body dementia

A

Lewy bodies deposited in substantia nigra and cortex
Parkinsonism
Visual hallucinations, acting out dreams, frequent falls

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6
Q

Types of frontotemporal dementia

A

Picks disease

Taupathies

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7
Q

Describe frontotemporal dementia

A

Altered personality and behaviour
Impaired judgment
Speech output decreases, eventual mutism

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8
Q

Management of dementia

A

Assessment of risk and capacity
Memory aids
Pharmacological: cholinesterase inhibitors, memantine

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9
Q

Definition of seizure

A

Sudden irregular discharge of electrical activity in brain causing a physical manifestation
Increased glutamate or decreased GABA

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10
Q

Definition of convulsion

A

Uncontrolled shaking movements due to rapid contraction and relaxation of muscles

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11
Q

Definition of aura

A

Perceptual disturbance some people experience prior to a seizure (usually partial)

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12
Q

Definition of epilepsy

A

Neurological disorder marked by sudden recurrent episodes of sensory disturbance, loss of consciousness or convulsions associated with abnormal electrical activity in brain

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13
Q

Definition of status ellipticus

A

Epileptic seizures occurring continuously without recovery of consciousness
A medical emergency, should get medical assistance if seizure >5 mins

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14
Q

Broad classes of seizures

A

Partial

Generalised

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15
Q

Classification of partial seizures

A

Simple - no loss of consciousness

Complex - impaired consciousness

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16
Q

Classification of generalised seizures

A 
Tonic clonic - muscles tense, then have convulsion 
Absence - 'daydreaming'
Status epilepticus
Myoclonic- muscle jerking 
Atonic - 'drop attack'
17
Q

Describe examples of partial seizures in order of more to less common

A

Temporal lobe epilepsy - usually have auditory aura, common in 1st or 2nd decade due to early brain injury

Frontal lobe epilepsy - usually have contralateral abnormal movements

18
Q

Investigations for epilepsy

A

Collateral history
EEG to assess risk of recurrence
MRI to exclude SOL

19
Q

What to find out from collateral history in suspected epilepsy

A

Before: PMH, FH, aura, triggers
During: duration, description of seizure, how it ended
After: incontinence, memory loss, post ictal

20
Q

Problems with using EEG for investigating epilepsy

A

May induce seizure as need to hyperventilate while having photic stimulation
Shouldn’t use unless history suggests epilepsy most likely explanation for symptoms

21
Q

What provides the anterior circulation of brain

A

ICA

22
Q

What provides the posterior circulation of brain

A

Vertebral artery

23
Q

Arteries making up anterior circulation of brain

A

Anterior cerebral
Middle cerebral
Anterior and posterior communicating

24
Q

Arteries making up posterior circulation of brain

A

Posterior cerebral
Basilar (pontine branches)
Vertebral (anterior spinal branches)
Cerebellar - superior, ant inferior, post inferior

25
Q

What do cerebellar arteries supply

A

Brainstem

Cerebellum

26
Q

What does the anterior cerebral artery supply

A

Medial frontal and parietal lobes

Corpus collosum

27
Q

What does the middle cerebral artery supply

A 
Lateral surface of hemispheres
Most of temporal lobe
Basal ganglia 
Internal capsule
Lentiform nucleus
28
Q

What does the posterior cerebral artery supply

A

Inferior temporal lobe
Occipital lobe
Thalamus

Neuro (19 decks)

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