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Brain > Misc Neuropsychiatry/Neuropsychology > Flashcards

Misc Neuropsychiatry/Neuropsychology Flashcards

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1
Q

What commonly used neuropsychological test is used to objectify mental flexibility/perseveration?

A

Wisconsin Card Sorting Test

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2
Q

What test can be used to elicit field dependence as well as defects in frontal lobe function?

A

Stroop Test

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3
Q

What do dorsolateral prefrontal cortex lesions yield?

A

Pseudo-depression - flattened affect, unresponsiveness and defects in higher-order cortical function

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4
Q

What do orbitofrontal prefrontal cortex lesions yield?

A

Pseudo-psychopathy; like a drunk teenager

Failure to modulate limbic structures leading to disinhibition and jollyness/anger bordering on mania

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5
Q

What 3 structures are thought to comprise the pain matrix?

A

Thalamus
Insula
Anterior cingulate cortex

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6
Q

What is thought to be the relationship between the prefrontal cortex, periaqueductal grey and pain matrix in perception of pain?

A

Increased prefrontal cortex activity -> increased opiate release from periaqueductal grey structures -> reduced activity and perception of pain in pain matrix

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7
Q

Who described utilisation behaviour?

A

Lhermitte

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8
Q

What is thought to be the malfunctioning region in utilisation behaviour?

A

Basal ganglia

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9
Q

What are the 3 major dopaminergic pathways?

A

Mesolimbic
Mesocortical
Nigrostriatal

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10
Q

Where does the mesolimbic tract project?

A

Nucleus accumbens

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11
Q

What does the nucleus accumbens integrate? What loop is it probably a part of?

A

Dopaminergic function from mesolimbic tract
Prefrontal cortex fibres
Amygdala and hippocampus
Part of the cortico-basal-thalamic loop

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12
Q

What is the sole source of histaminergic pathways in the brain? Where is it found?

A

Tuberomammilary nucleus

In the posterior hypothalamus

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13
Q

What is the main role of the tuberomammilary nucleus and where is it found?

A

In the posterior hypothalamus - produces histaminergic pathways

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14
Q

What affect do histaminergic pathways have on arousal and cortical activation?

A

They increase it directly via cortical projections and indirectly via acetylcholine release from forebrain/pons

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15
Q

Where do the major dopaminergic pathways originate?

A

Ventral tegmental area

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16
Q

What is Anton-Babinski syndrome?

A

Cortical blindness + visual anosognosia

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17
Q

What are the 2 most common disease causing VGKC antibodies?

A

LGI1

Caspr2

18
Q

What is the third type of VGKC antibody not associated with tumours?

A

Anti-DDPX

19
Q

What CSF changes are seen in VGKC disease?

A

Often none

20
Q

What is the typical presentation of LGI-1 disease?

A

Cognitive impairment and seizures
Hyponatraemia
Sleep disorder
Movement disorder

21
Q

What phenomenon is the hallmark of VGKC disease?

A

Peripheral nerve hyperexcitability

Or central nerve hyperexcitability presenting with limbic encephalitis

22
Q

What VGKC antibody classically causes cognitive impairment and seizures?

A

LGI-1

23
Q

What is the classical presentation of CASPR-2 disease?

A

Morvan’s syndrome

Neuromyotonia

24
Q

What 3 conditions fall under the umbrella of peripheral nerve hyperexcitability?

A

Benign fasciculation syndrome
Mild cramp fasciculation syndrome
Neuromyotonia

25
Q

What is neuromyotonia?

A

Peripheral nerve hyperexcitability with muscle twitching, cramps, sweating, dysaesthesia, dystonia
Often muscle hypertrophy and myokymia

26
Q

What is myokymia?

A

Involuntary spontaneous localised muscle twitching e.g. Lower eyelid spasm

27
Q

What is the name for the peripheral nerve hyperexcitability phenomenon of muscle twitching, cramps, sweating, dysaesthesia in association with muscle hypertrophy and myokymia?

A

Neuromyotonia

28
Q

What is suggestive of Neuromyotonia in terms of the presence of myokymia?

A

Present in unrelated muscle groups

29
Q

What is Morvan’s syndrome/Morvan’s Fibrillary Chorea?

A

Florid Neuromyotonia
Cognitive impairment
Sleep disorder
Autonomic dysfunction - sweating, cardiac arrythmias

30
Q

What syndrome is suggested by neuromytonia, autonomic dysfunction, cognitive impairment and sleep disorder?

A

Morvan syndrome

31
Q

What is the pathology underlying Morvan syndrome? Specific Ab?

A

VGKC antibodies causing peripheral nerve hyperexcitability

Often CASPR-2

32
Q

What tumour is occasionally seen in VGKC disease?

A

Thymoma

33
Q

What virus can cause an indolent, slowly progressive limbic encephalitis?

A

HSV6

34
Q

What is the nature of a classical amyloidosis neuropathy?

A

Painful, with autonomic involvement

35
Q

What are the 3 classical features of POEMS?

A

Plasma cell proliferative disorder (myeloma)
Polyneuropathy
Multi organ damage

36
Q

What is interesting about the myeloma seen in POEMS?

A

Tends to be osteosclerotic rather than osteolytic, which is common in normal myeloma

37
Q

What does POEMS stand for?

A 
P- Papilloedema, pulmonary disease and peripheral Polyneuropathy
O- organomegaly (liver), oedema
E- endocrinopathy (mostly sex hormones)
M- monoclonal paraprotein (IgG, lambda)
S- skin changes
38
Q

What is the paraprotein type in most paraproteinaemic Neuropathies? What about POEMS?

A 
IgM 
Usually IgG (occasionally A) in POEMS
39
Q

3 abnormal blood results seen in POEMS?

A

Thrombocytosis
Polycythaemia
Increased blood VEGF

40
Q

What stain is best for observing amyloidosis on biopsy tissue?

A

Conga Red

Brain (22 decks)

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