Memory Disorders

Question 1

What is memory?

Answer 1

A higher cortical function
Of acquisition and retrieval
Of stimuli

Acquisition

Recognition, registering and cataloguing of a stimulus(verbal, visual, episodic, semantic)

Retrieval

Appropriate recall

Question 2

What are the types of memory disorders?

Answer 2

Amnesic syndromes
Senescence
Dementia

Question 3

What is dementia?

Answer 3

Diffuse cerebral disease syndrome

Loss of higher cortical function

Memory impairment

Plus at least one more cognitive domain

• aphasia
• apraxia
• agnosia
• executive

Declining functional level of ADLs, social

Question 4

What is the classification of dementias?

Answer 4

Primary
Potentially reversible

Primary

• AD 60%
• Vascular dementia 20%
• dementia with Lewy bodies 10%
• frontotemporal lobar degeneration 5%

Potentially reversible

• Chronic SDH
• Prion disease CJD, HIV, syphillis
• frontal tumor
• Parkinson’s, Huntington’s, NPH
• Vasculitis, MS
• head injury
• hepatic encephalopathy, hypothyroidism, hypoglycemia
• vitamin B12 deficiency

Question 5

What are the investigations for dementia?

Answer 5

NON INVASIVE

• CT MRI
• Neuropsychometry
• EEG
• genetics

INVASIVE

• Thyroid profile
• VDRL
• HIV
• ESR CRP
• B12 Folate
• brain biopsy

Question 6

What is Alzheimer’s disease?

Answer 6

Most common Degenerative brain disease

Most common cause of dementia

Affect elderly >65

Females > males

Familial cases are less common

More common in Down’s syndrome

Question 7

What is the pathology of AD?

Answer 7

Generalized cortical atrophy

Especially hippocampus, temporal lobe, parietal lobe

Mutation of amyloid precursor protein gene on chromosome 21

Cortical amyloid A4 deposits

Extra cellular Neuritic plaques

Intercellular Neurofibrillary tangles

Question 8

What are the features of normal pressure hydrocephalus?

Answer 8

Triad of

• dementia
• gait disturbance
• urinary incontinence

Occurring in conjunction with hydrocephalus and normal CSF pressure

Question 9

What are the Clin features of AD?

Answer 9

EARLY
Insidious slowly progressive episodic memory loss
Deficit of new learning
Visuo-spatial disorientation 
Executive Functional loss

LATE
Behavior and thinking deficits
Complete loss of short term episodic memory
Semantic memory lost
Dysphasia- Language dysfunction
Apraxia- unable complex multi-step motor activity
Dependent

TERMINAL
Fully dependent
No memory
Myoclonus
Seizures
Extrapyramidal signs
Death