Neuro - Anat & Phys (Common brain lesions, Central pontine myelinolysis, & Aphasia)

Question 1

What syndrome is the consequence of an amygdala (bilateral) lesion? What 3 symptoms define this syndrome?

Answer 1

Kluver-Bucy syndrome (hyperorality, hypersexuality, disinhibited behavior)

Question 2

With what pathogen is Amygdala (bilateral) lesion and/or Kluver-Bucy syndrome associated?

Answer 2

Associated with HSV-1

Question 3

What are 3 deficits to associate with a frontal lobe lesion? What else is associated with this lesion?

Answer 3

Disinhibition and deficits in concentration, orientation, and judgement; May have reemergence of primitive reflexes

Question 4

What is the consequence of a right parietal-temporal cortex lesion?

Answer 4

Spatial neglect syndrome (agnosia of the contralateral side of the world)

Question 5

What syndrome is the consequence of a left parietal-temporal cortex lesion? What 4 symptoms characterize this syndrome?

Answer 5

Gerstmann syndrome; Agraphia, acalculia, finger agnosia, and left-right disorientation

Question 6

What consequence does a reticular activating system (midbrain) lesion have? What is an example of this consequence?

Answer 6

Reduced levels of arousal and wakefulness (e.g., coma)

Question 7

What syndrome is the consequence of a mammillary bodies (bilateral) lesion? What are the 2 defining sets of symptoms of this syndrome, and with which part of the syndrome are each set of symptoms associated?

Answer 7

Wernicke-Korsakoff syndrome: Confusion, Ophthalmoplegia, Ataxia (Wernicke); Think: “Wernicke problems come in a CAN of beer: Confusion, Ataxia, Nystagmus.” Memory loss (anterograde and retrograde amnesia), confabulation, personality changes (Korsakoff)

Question 8

With what lesion is Wernicke-Korsakoff syndrome associated? With what conditions/risk factors is Wernicke-Korsakoff syndrome associated? What is a precipitating factor of this pathology?

Answer 8

Mammilary bodies (bilateral); Associated with thiamine (B1) deficiency and excessive EtOH use; Can be precipitated by giving glucose without B1 to a B1-deficient patient

Question 9

What are 3 possible symptoms/consequences of basal ganglia lesion? What is a disease to associate with this lesion?

Answer 9

May result in tremor at rest, chorea, or athetosis; Parkinson disease

Question 10

What are 3 symptoms/consequences of a cerebellar hemisphere lesion?

Answer 10

(1) Intention tremor (2) Limb ataxia (3) Loss of balance; Think: “Cerebellar hemispheres are LATERALly located - affect LATERAL limbs.”

Question 11

Does damage to the cerebellum result in contralateral or ipsilateral deficits? Does the patient with cerebellum damage and thus loss of balance fall toward or away from the side of the lesion?

Answer 11

Damage to cerebellar results in ipsilateral deficits; Fall toward side of lesion

Question 12

What consequence is associated with a subthalamic nucleus lesion?

Answer 12

Contralateral hemiballismus

Question 13

What is the consequence of a hippocampus (bilateral) lesion?

Answer 13

Anterograde amnesia - inability to make new memories

Question 14

What is the consequence of a paramedian pontine reticular formation?

Answer 14

Eyes look away from side of lesion

Question 15

What is the consequence of a frontal eye fields lesion?

Answer 15

Eyes look toward lesion

Question 16

Central pontine myelinolysis is a variant of what syndrome?

Answer 16

A variant of osmotic demyelination syndrome

Question 17

What are 5 symptoms that characterize central pontine myelinosis?

Answer 17

(1) Acute paralysis (2) dysarthria (3) dysphagia (4) diplopia (5) loss of consciousness

Question 18

What syndrome can central pontine myelinolysis cause?

Answer 18

Can cause “locked-in syndrome”

Question 19

What major abnormality is seen in pons during central pontine myelinolysis, and what (in general) causes this change?

Answer 19

Massive axonal demyelination in pontine white matter tracts secondary to osmotic forces and edema

Question 20

What is a common cause of central pontine myelinolysis?

Answer 20

Commonly iatrogenic, caused by overly rapid correction of hyponatremia

Question 21

What happens if you correct serum Na+ too fast in each of the following contexts: (1) From low to high (2) From high to low?

Answer 21

Correcting serum Na+ too fast: (1) “From low to high, your pons will die” (CPM) (2) “From high to low, your brain will blow” (cerebral edema/herniation)

Question 22

What is aphasia versus dysarthria? Which kind of deficit is each?

Answer 22

Aphasia: high-order inability to speak language (language deficit); Dysarthria: motor ability to speak (movement deficit)

Question 23

Where is the Broca area?

Answer 23

Broca area - Inferior frontal gyrus of frontal lobe

Question 24

Define Broca aphasia.

Answer 24

Nonfluent aphasia with intact comprehension; Think: “Broca Broken Boca (boca = mouth in Spanish)”

Question 25

Where is Wernicke area?

Answer 25

Wernicke area - Superior temporal gyrus of temporal lobe

Question 26

Define Wernicke aphasia.

Answer 26

Fluent aphasia with impaired comprehension and repetition; Think: “Wernicke is Wordy but makes no sense. Wernicke = What?”

Question 27

Define Global aphasia. What is affected?

Answer 27

Nonfluent aphasia with impaired comprehension; Both Broca and Wernicke areas affected

Question 28

Define Conduction aphasia. What are patients with this aphasia unable to do?

Answer 28

Poor repetition but fluent speech, intact comprehension; Can’t repeat phrases such as, “No ifs, ands, or buts.”

Question 29

What are 2 areas to which damage can cause Conduction aphasia?

Answer 29

Can be caused by damage to left superior temporal lobe and/or left supramarginal gyrus

Question 30

Define transcortical motor aphasia.

Answer 30

Nonfluent aphasia with good comprehension and repetition.

Question 31

Define transcortical sensory aphasia.

Answer 31

Poor comprehension with fluent speech and repetition.

Question 32

Define mixed transcortical aphasia.

Answer 32

Nonfluent speech, poor comprehension, good repetition.