Focal brain syndromes

Question 1

What symptoms can be seen in dorsolateral prefrontal cortex damage (frontal lobe) & what are typical causes?

Answer 1

classic dysexecutive syndrome

Typical causes: tumours, CVA, frontal neurodegeneration

Question 2

What signs show damage of the orbital prefrontal cortex and typical causes?

Answer 2

disinhibition, restlessness, impulsiveness, impaired empathy

Typical causes: frontal tumours, MS, frontal neurodegeneration, anterior cerebral artery CVA

Question 3

What are signs of damage to the medial prefrontal cortex and what are typical causes?

Answer 3

apathy and loss of initiative

Typical causes: trauma, hydrocephalus, bilateral anterior cerebral artery occlusion and tumours of the thalamus, 3rd ventricle, hypothalamus and pituitary

Question 4

Signs of impairment to non-dominant parietal lobe?

Answer 4

disturbed body image and impaired sense of position in external space, left sided neglect

Question 5

What are signs for a lesion in the dominant parietal lobe?

Answer 5

dysphasia, agnosia

Question 6

How to devide the temporal lobe?

Answer 6

lateral and ventromedial

Question 7

What includes the lateral temporal lobe?

Answer 7

neocortex (cognitive functions)

Question 8

What is included in the ventromedial temporal lobe?

Answer 8

components of limbic system (emotional regulation)

Question 9

Signs of damage to dominant temporal lobe:

Answer 9

language problems (Wernickes aphasia)

Question 10

What can a lesion of the acuate fasciculus lead to?

Answer 10

Connecting Wernickes and Brocas area it leads to conduction aphasia (difficulty with repetition)

Question 11

What are non-dominant temporal lesions associated with?

Answer 11

visuospatial problems

Question 12

What emotions can be present with TLE seizures

Answer 12

fear,
anxiety,
pleasure,
depersonalisation,
depression,
déjà vu (familiarity) and jamais vu (unfamiliarity).

Question 13

What can a bilateral hippocampal lesions lead to?

Answer 13

severe amnestic syndromes

Question 14

What can a bilateral distruction of the amygdala cause?

Answer 14

loss of fear

Question 15

Are lesions of the occipital lobe common?

Answer 15

Yes due to strokes

Question 16

What can lesions of the primary visual cortex lead to?

Answer 16

• blind spots (scotomas)
• partial blind spots (amblyopias)

Question 17

What can bilateral lesions of the occipital lobe lead to?

Answer 17

object agnosia or prosopagnosia (autoprosopagnosia)

Question 18

What are key features of the Balint syndrom?

Answer 18

• inability to perceive the visual field as a whole (simultanagnosia),

-difficulty in fixating the eyes (oculomotor apraxia)

-inability to move the hand to a specific object by using vision (optic ataxia).

Question 19

What can excessive bilateral occipital cortex lesions lead to?

Answer 19

Cortical blindness

Question 20

What is Anton’s syndrome

Answer 20

Denial of visual loss

Question 21

What do lesions of the dominant occipital lobe lead to?

Answer 21

pure alexia for written material, colour agnosia, simultagnosia

Question 22

What can bilateral occipitoparietal lesions cause?

Answer 22

Charcot-Wilbrand syndrome (loss of ability to create mental visual images)

Question 23

Complete callosal damage may lead to…

Answer 23

… left ideomotor apraxia, right or bilateral constructional apraxia, left agraphia, alexia in the left visual field and astereognosis in the left hand. Mutism may also occur.

Question 24

What has been often observed after a callosectomy and why?

Answer 24

left sided neglect due to underactivation of non-dominant hemisphere

Question 25

What can lesions of deep midline structures lead to?

Answer 25

hypersomnia, akinetic mutism, intellectual decline, etc.

Question 26

What are basal ganglia lesions associated with?

Answer 26

Tourette’s, dementia, depression, obsessive-compulsive disorder (OCD), apathy, aphasia, psychosis and mania, huntingtons, parkinsons, wilsons disease.

Question 27

When can the cerebellar cognitive affective syndrome occur?

Answer 27

disrupted connections to the cerebral cortex and limbic system

Question 28

What is the source of monoamine neurotransmitter circuits?

Answer 28

brainstem

Question 29

What is the locked-in syndrome

Answer 29

Impairment to brainstem: paralysis of all four limbs and paralytic mutism. Cognition may be impaired: attention, memory difficulties as well as deficits in mental calculation, problem solving, auditory and visual recognition, and receptive language.

Question 30

Frontal Lobe damage:

Answer 30

leads to the dysexecutive syndrome. This leads to personality, affective or behavioural changes, working memory problems, indifference, distractibility, emotional instability, diminished anxiety, impulsiveness, facetiousness, euphoria, lack of initiative and impaired planning ability.

Question 31

Parietal lobe damage:

Answer 31

deficits in processing sensory information from various parts of the body, dyscalculia, visuospatial processing problems, difficulty with navigation and manipulation of objects in space.

Question 32

Temporal lobe damage

Answer 32

deficits in language and memory as well as behavioural changes including aggression, mood changes and psychosis.

Question 33

Occipital lobe lesions

Answer 33

• deficits in higher order visual processing such as visual objects agnosia and prosopagnosia. There may also be hallucinations and visual distortions