Introduction to neuropsychiatry

Question 1

Psychotic symptoms

Answer 1

hallucinations
delusions
misidentifications

Question 2

affective symptoms

Answer 2

depression 
anxiety 
apathy 
elation 
disinhibition

Question 3

behavioural symptoms

Answer 3

aberrant motor behaviour 
irritability/aggresion 
agitation 
sleep disturbance 
stereotypes 
hyperorality 
eating disturbance 
hyper sexuality

Question 4

frontal lobe is responsible for

Answer 4

• judgement
• reasoning
• behaviour
• voluntary movements
• expressive language

Question 5

temporal lobe is responsible for:

Answer 5

• emotions
• learning and memory
• audition
• olfaction
• language comprehension

Question 6

parietal lobe

Answer 6

• spatial orientation
• perception
• initial cortical processing of tactile and proprioceptive information

Question 7

what is the difference between parkinsons disease and dementia with leeway bodies

Answer 7

based on the time of onset of motor and cognitive symptoms

• motor first = parkinsons
• cognitive first = Lewy body dementia

Question 8

what are the microbiological differences in PDD and lewy body dementia

Answer 8

• more pronounced cortical atrophy

- higher Abeta and tau loads in cortex and striatum

Question 9

Mania

Answer 9

oribitofrontal prefrontal cortex-impulsivity, mood lability,

Question 10

Pseudobulbar affect

Answer 10

10% MS patients-disconnect between mood and affect- ‘tears without sadness’

Question 11

Psychosis in MS patients

Answer 11

2-3 x more common in MS patients compared to general population e.g medial temporal damage

Question 12

Huntington’s Disease

Answer 12

• Abnormal huntingtin protein leads to degeneration of neurons- particularly caudate, putamen and cerebral cortex

Question 13

what are the symptoms of Huntington’s

Answer 13

• Progressive dementia and movement disorder
• Early depression and behavioural disturbances common- especially irritability, apathy, anxiety, dysphoria and agitation- independent of cognitive and motor aspects
• Psychotic symptoms rare
• Insight retained until late stages
• High suicide rate ~ 10%

Question 14

Motor Neurone Disease (ALS)

Answer 14

• Neuropsych symptoms may precede motor symptoms
• Cognitive and behavioural deficits in up to 50% - executive function, social and language deficits- dementia (FTD type)
• Familial MND and FTD have genetic overlap- trinucleotide expansion in C9orf72

Question 15

Functional Neurological Disorder

Answer 15

• Occur in about one quarter of neurology clinic patients
• problem with the functioning of the nervous system and how the brain and body sends and/or receives signals, rather than a structural disease process such as multiple sclerosis or stroke.
• Eg limb weakness/paralysis, seizures, tremors, slurred speech, blackouts
• Symptoms are real, often fluctuate
• May also have chronic pains, fatigue, sleep problems, memory symptoms, bowel and bladder symptoms, anxiety and depression.

Question 16

functional MRI of FND

Answer 16

hyperconnectivity between caudate, amygdala, prefrontal and sensorimotor areas