Memory & Dementia Flashcards
How is the hippocampus involved in memory?
Locating memories in the right time,place & context
How is the amygdala involved in memory?
Stores emotionally charged memories
What is the role of the medial prefrontal cortex in memory?
Connected to the amygdala
Regulates emotional & fear responses
What is Vitamin B1 also known as?
Thiamine
What is Korsakoff’s amnesia?
Severe thiamine deficiency
Bilateral loss of mamillary bodies in the brain
Anterograde amnesia
What is the neuropathology of Alzheimer’s?
Beta amyloidplaques
Tauprotein build up - NFtangles
Which are is first affected in Alzheimers?
Nucleus basalis of Menert
How does Alzheimer’s present?
Gradual memory loss
Disorientation
Nominal dysphasia
How is mild-moderate Alzheimer’s treated?
Cholinesterase inhibitors (Donepizil, Rivastigmine)
How is severe Alzheimer’s treated?
Memantine
What is the neuropathology seen in vascular dementia?
Multiple mini infarcts
White matter pallor
Perivascular tissue loss & dilation of perivascular spaces
How does vascular dementia present?
Sudden onset
Stepwise detrioration
How is vascular dementia managed?
Anti-platelets
Lifestyle modification
If carotid stenosis is >70% - carotid endartectomy
What is the neuropathology seen in Lewy Body dementia?
alpha-synuclein inclusion in SN, paralimbic & neocortical areas
Decrease dopamine uptake in basal ganglia seen in SPECT & PET scans
What are the features of Lewy Body dementia?
Neuroleptic sensivity (irreversible parkinsonism) Fluctuating cognition Parkinsonism Visual hallucinations REM sleep behaviour disorder Falls
How is Lewy Body dementia treated?
Cholinesterase inhibitors +/- dopaminergics
How is REM behaviour disorder in Lewy Body dementia treated?
Clonazepam or melatonin
What neuropathology is seen in fronto-temporal dementia?
Picks bodies ( tau +ve spherical cytoplasmic neuronal inclusions) Picks cells (ballooned neurons with dissolution of chromatin) Frontotemporal atrophy without Alzheimer histology
Features of fronto-temporal dementia?
Personality change
Progressive loss of language fluency
Memory impairment
How does delirium present?
Impaired consciousness Disturbance of cognition Psychomotor disturbance Disturbance of sleep-wake cycle Emotionaldisturbance
What isthe treatment for acute delirium?
Halooperidol then Lorazepam
What percentage of stroke patients suffer post stroke depression?
Up to 1/3
How does Wernicke’s encephalopathy present?
Ataxia Confusion Meningism Nystagmus Headache Hallucinations
What causes Wernicke’s encephalopathy?
Thiamine deficiency
