Neurology- Dementia & Encephalopathy

Question 1

Signs and symptoms of Creutz-Jakob disease

Answer 1

progressive dementia
myoclonus
pyramidal/ extrapyramidal dysfunction 
mutism 
↑ CSF 13-3-3 protein

Question 2

EEG seen with Creutzfeldt-Jakob

Answer 2

generalized slowing with periodic sharp wave complexes

Question 3

Presentation of behavioral variant Frontotemporal dementia

Answer 3

Compulsive behavior
Hyperorality/ eating changes
Executive dysfunction
Apathy, disinhibition
Frontal temporal atrophy on imaging

Question 4

Brain abnormalities in behavior variant frontotemporal dementia

Answer 4

Accumulation of tau protein inclusions known PICK bodies in the hippocampi, temporal lobes and frontal lobes

Question 5

Management of frontotemporal dementia

Answer 5

SSRI or trazadone have demonstrated some benefit in the Management of neuropsych symp.

Question 6

Psudodementia

Answer 6

Older patients with severe depression that demonstrate cognitive impairment and slowing.

Depression-related cognitive impairment is potentially reversible and can improve with tx of underlying depression

Question 7

Lewy body Dementia

Answer 7

Form of degenerative dementia characterized by eosinophilic cytoplasmic inclusions of alpha-synuclein (levy Bodies( in the brain

Question 8

S&S Lewy body dementia

Answer 8

Fluctuating cognition & attention
Visual Hallucinations and delusions 
REM sleep behavior disorders 
Parkinsonism 
Severe sensitivity to antipsychotics 
Falls/ syncope

Question 9

Diagnosis normal pressure hydrocephalus

Answer 9

Elargment of ventricles out of proportion to the sulk on imaging.

Confirmed with improvement after high volume lumbar puncture or lumbar drain placement

Question 10

Normal pressure hydrocephalus mechanism

Answer 10

reduced CSF reabsorption with occurs due to elevated central pressures or chronic periventricular ischemia.

Question 11

TX normal pressure hydrocephalus

Answer 11

definite treatment: ventricular shunt