Hemineglect and mental status exam

Question 1

Hemineglect

Answer 1

Impaired ability to orient toward one side
- PRESERVED motor and sensory functions
-

Question 2

How do you test for hemineglect

Answer 2

1. Double simultaneous stimulation - visual or tactile
2. Line bisection
3. cancellation test

Question 3

If you have a LEFT parietal lesion - look for

Answer 3

DOMINANT hemisphere -

GERSTMANNS SYDROME

Question 4

Characteristic features of gerstmann’s

Answer 4

1. acalculia
2. agraphia without alexia
3. Finger agnosia
4. Impaired left/right discrimnation
   - ideational apraxia

Question 5

Other tests of cortical sensory fxn

Answer 5

1. Graphesthesia
2. 2-point discrimination
3. Point localization

Question 6

Hemineglect OFTEN indicates a

Answer 6

RIGHT parietal lesion

- right parietal lobe attends to both hemispheres - dont see neglect with a left stroke

Question 7

If it’s not in the right parietal lobe

Answer 7

1. Right prefrontal
2. Right cingulate gyrus
3. Right striatum, posterior internal capsule, and thalamus

Question 8

Causes of hemineglect

Answer 8

STROKE
STROKE
POST-ICTAL

Question 9

Which artery often affected in parietal lesion

Answer 9

MCA

Question 10

Neighbourhood signs of MCA infarct

Answer 10

1. Anosagnosia

2. Field cut

Question 11

Attention can defy localization how

Answer 11

1. monitor
2. select
   NOT JUST FRONTAL LOBE - brainstem thalamic arousal system and cerebellum

Question 12

What is apraxia

Answer 12

inability to perform movements in response to a command - often skilled or learned movements

Question 13

ideomotor vs ideational

Answer 13

ideational is sequence problem

Question 14

How do you lose praxis?

Answer 14

1. Disconnection/destructtion of DOMINANT HEMISPHERE association areas
2. NOT hemiparesis, hemisensory deficits, cerebellar, or aphasias

Question 15

Differential diagnosis of Ideomotor apraxia

Answer 15

1. 80-90% non fluent primary progressive/corticobasal syndrome
2. 70-80% Alzheimer’s disease
3. 70& PSP
4. 28-57% STROKE
5. 25% Parkisons

Question 16

Frontal lobe functions

Answer 16

1. sustained attention’
2. set shifting
3. self-monitoring
4. energization -