Introduction to Neuropsychiatry

Question 1

What are some of the psychotic symptoms of dementia?

Answer 1

Hallucinations, Delusions and misidentifications.

Question 2

What are the impacts of behavioural and psychological symptoms of dementia (BPSD) or neuropsychiatric symptoms?

Answer 2

They are very common and are likely to be the most problematic aspect for carers, and be a major source of caregiver distress. Both symptoms are strongly associated with nursing home placement.

Question 3

What are the general functions of the frontal lobe?

Answer 3

Judgement, reasoning, behaviour, voluntary movements and expressive language.

Question 4

What are the general functions of the temporal lobes?

Answer 4

Emotions, learning and memory, audition, olfaction and language comprehension.

Question 5

What are the functions of parietal lobes?

Answer 5

Spatial orientation, perception, initial cortical processing of tactile and proprioceptive information and language comprehension.

Question 6

Where does Alzheimer’s primarily affect?

Answer 6

Temporo-parietal area but can progress through the cortex over time

Question 7

What is the difference between Lewy body dementia and Parkinson’s disease dementia?

Answer 7

They share many clinical, neurochemical and morphological features and distinction is based on what comes first; movement disorder or cognitive symptoms (dementia)

Question 8

What are two key core diagnostic criterias for fronto-temporal dementia?

Answer 8

• Behavioural disorder eg, loss of social awareness, signs of disinhibition.
• Affective symptoms such as depression, anxiety but also emotional unconcern

Question 9

Name an example of a core diagnostic criteria for vascular dementia?

Answer 9

Psudobulbar palsy - Personality and mood changes, abulia (lack of will power), depression, emotional incontinence.

Question 10

What are some likely psychiatric symptoms of a patient with multiple sclerosis?

Answer 10

Clinical depression in 50%,
Suicide,
Mania,
Pseudobulbar affect (disconnect between mood and affect, eg, tears without sadness),
Psychosis is 2-3x more common

Question 11

Where is the main damage to the brain in Huntington’s disease?

Answer 11

Caudate and putamen as well as cerebral cortex.

Question 12

What are some of the neuropsychiatric symptoms of Huntington’s disease?

Answer 12

• Early depression and behavioural disturbances are common but psychotic symptoms are rare.
• Due to insight being retained until late stages there is a high suicide rate of 10%

Question 13

What are the features of neuropsychiatric conditions in motor neuron disease?

Answer 13

• The neuropsych symptoms may precede motor symptoms.

- Has genetic/familial overlap with FTD (trinucleotide expansion)

Question 14

What are some other names for functional neurological disorder?

Answer 14

• Functional movement disorder,
• Conversion disorder,
• Psychogenic seizures,
• Dissociative seizures,
• Non-epileptic seizures

Question 15

What are functional neurological disorders?

Answer 15

They are problems with the functioning of the nervous system and how the brain and body sends and/or recieves signals.
Symptoms can include limb weakness/paralysis, seizures, tremors, slurred speech and blackouts. Symptoms can be improved with physio!

Question 16

What is the cause of functional neurological disorders?

Answer 16

Triggers such as past trauma, stress, migraine, physical injury and infection which triggers abnormal patterns of brain functions.