Introduction to neuropsychiatry Flashcards
what is neuropsychiatry?
Psychiatric symptoms in the context of neurological disorder
Describe the 3 strands of symptoms of dementia
- Psychotic symptoms e.g. hallucinations, delusions, misidentifications
- Behavioural symptoms e.g. agitation, irritability, stereotypies
- Affective symptoms e.g. depression, anxiety, apathy, elation
What is the Frontal lobe responsible for?
- Judgement
- Reasoning
- Behaviour
- Voluntary movements
- Expressive language (Broca’s area)
What is the parietal lobe responsible for?
- Spatial orientation
- Perception
- Initial cortical processing of tactile and proprioceptive information
- Language comprehension (Wernicke’s area)
What is the temporal lobe responsible for?
- Emotions
- Learning and memory
- Audition
- Olfaction
- Language comprehension (wernickes area)
Describe the primary symptoms for probable Alzheimer’s
• Initially temporal- parietal: symptoms initially memory related, spatial awareness
• impaired activities of daily living
(• depression, insomnia, incontinence, delusions, illusions, hallucinations, verbal or physical outbursts, sexual disorders, weight loss)
Describe the primary symptoms for probable lewy body dementia
- Hallucinaitons and delusions
- Defective cholinergic activity
- Spontaneous motor features of Parkinsonism
What are the differences between Parkinson’s disease dementia and lewy body dementia?
• Distinciton based on time of onset of motor and cognitive symptoms
• In Lewy body dementia there is:
- more pronounced cortical atrophy
- elevated cortical and limbic Lewy body pathology
- higher AB and Tau loads in the cortex and striatum
• Earlier cognitive defects in Lewy body dementia
Describe the primary symptoms of frontal-temporal dementia
- Early loss of personal and social awareness
* Can be violent, hyper sexual, impulsive, depressed/anxious, lack of empathy and apathy
Describe vascular dementia
• Can affect the whole brain
• Sometimes presents with pseudo-bulbar palsy
- disconnect between the situation and their emotions
Describe the neuropsychological symptoms of MS
- Dysphoria, agitation, anxiety and irritability
- Major depressive disorder in approx. 50%, likely to reflect cortical damage, not just reaction to the disease
- Suicide rates high
- Mania e.g. orbitofrontal prefrontal complex - impulsivity, mood liability, personality changes
- Pseudobulbar affect. (10%)
- psychosis is 2-3 times as common in MS patients in comparison to the general population
Which parts of the brain are particularly affected in Huntington’s
Degeneration of neurones particularly in the
• Caudate
• Putamen
• Cerebral cortex
- results in increased size of lateral ventricles
What are the neuropsychological symptoms of Huntington’s disease?
- progressive dementia and movement disorder
- Early depression and behavioural disturbances are common
- Psychotic symptoms are rare
- Insight retained in the late stages
- High suicide rate (approx 10%)
What is a functional neurological disorder?
A 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
