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Neuropsych Flashcards

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1
Q

Epilepsy

A

Two or more unprovoked seizure, occurring less than 24 hours apart

Seizure disorders are caused by abnormal electrical activity in the brain; sudden electrical discharge in brain; leads to altered behaviour, consciousness or sensation

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2
Q

Causes for epilepsy

A
  1. Symptomatic - Structural abnormality in the brain (tumour) or symptom of comorbid condition (dementia or encephalitis)
  2. Idiopathic - Genetic; no other known cause
  3. Cryptogenic - Unknown cause
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3
Q

Stages of a seizure

A

Pre-ictal or prodrome – time before you get hit by the seizure

Ictal – when you experience your seizure
Inter-ictal period - Report emotional disturbances (anxiety & depression); characteristic patterns of brain waves associated with this

Post-ictal period - Brain activity back to normal; left feeling fatigued; vary in duration; confusion

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4
Q

Partial seizures

A

Simple partial - Twitching & posturing; sweating & altered heart rate; deja vu or jamais vu; pins and needles, olfactory sensation, electrical sensations

Complex partial - Lose consciousness; confused after seizure; automatisms; staring spells, screaming, running

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5
Q

Generalized seizures

A

Absence seizures - Mostly found in children; brief loss of awareness; sudden onset & no warning; staring episode (less than 15 seconds, looks like daydreaming, come back to normal alertness levels)

Tonic Clonic seizures - Jerky movements; tonic phase (body stiffens, loss of consciousness, upward rolling of eyes); clonic phase (muscle spasm, elbows, legs and head flexes)

Atonic seizure - Sudden loss of muscle tone (go limp); consciousness preserved; drop attacks; start in childhood till older (need to wear helmets to protect head)

Myoclonic seizures - Muscle jerks; muscles contract and relax; mistaken for clumsiness

Tonic seizures - Muscles become rigid; mostly while sleeping; might fall if standing

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6
Q

West’s syndrome

A
  • Pediatric epilepsy syndrome
  • Characterized by infantile spasms – head nods; developmental delay
  • 5-30 seconds
  • Mental retardation is common
  • Progressive disorder
  • Kids don’t survive beyond 5 years of age
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7
Q

Dravet’s syndrome

A
  • Syndrome of infancy
  • Genetic
  • 5 seizures before 12 months
  • Onset by 7 months
  • Last longer than 10 min
  • Learning difficulties common
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8
Q

Temporal lobe epilepsy

A
  • Begins with aura
  • Blank state
  • Oromotor automatisms
  • Tonic or dystonic (abnormal tone) upper limb posturing
  • Head and/or eye deviations
  • Speech arrest
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9
Q

Frontal lobe epilepsy

A
  • Second most common type of focal epilepsy
  • Seizures typically brief (< 30 seconds)
  • Occurs in clusters, often multiple times a day
  • Post ictal confusion is minimal or absent
  • Semiology is often ‘bizarre’
  • Abrupt onset of stereotyped hypermotor behaviour
  • May look like individual is laughing or crying
  • Jacksonian march – look like they’re marching
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10
Q

Ischemic stroke

A

Caused due to narrowing or blockage of blood supply, leading to loss of blood flow

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11
Q

Hemmohragic stroke

A

Burst of blood vessel leading to infarction

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12
Q

Thrombosis

A

Blockage of blood vessel due to coagulated blood

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13
Q

Embolism

A

Blockage in blood vessel due to other reason - fatty tissue, air, hardened tissue

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14
Q

Types of strokes

A

Lacunar infarcts - silent strokes, small parts of the brain lose blood

Massive strokes - large parts lose blood

Transient Ischemic Attack - Becoming amnesiac for period; less than 10 min; pins & needles; transient deficit in cognitive and physical abilities

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15
Q

Post stroke cognitive profile

A
  • White and grey matter cell death
  • Psychological symptoms
  • Fall in attention, info processing, executive abilities
  • Localized deficits
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16
Q

Common effects post stroke

A

Paralysis - can’t move or feel parst of body
Hemiplegia - can’t move or feel one side of body
Hemiparesis - weakness on one side of body
Hemianopia - info from one half of visual field doesn’t reach visual cortex

17
Q

Types of Aphasia

A

Symptom of stroke

  • Broca’s: articulation difficulties; telegraphic speech
  • Wernicke’s: Comprehension difficulties; irrelevant speech
  • Conduction: trouble repeating info; damage to arcuate fasciculus that connect Broca’s & Wernicke’s
18
Q

Prosopagnosia

A
  • Face blindness
  • Inability to identify faces
  • Caused by damage to the fusiform face area (located at the occipito-temporal junction)
19
Q

Post traumatic amnesia

A
  • Period of confusion after traumatic brain injury
  • Disorientation, memory difficulties, confusion
  • Last from minutes to day
  • Reasons:
  • Memories are often lost due to psychological repression of unpleasant memories
  • Info may be incompletely encoded if events interrupt normal process of transfer from short to long term (transfer from hippocampus to frontal lobe is interrupted; things that have already made that transition aren’t affected)
  • Traumatic stress events lead to long term physical reduction of volume of hippocampus
20
Q

Retrograde amnesia

A
  • Loss of memory for events before impact
  • Follows damage to any part of the brain other than the hippocampus (for new memories) since long term memory is stored in neurons and synapses of various different brain regions.
  • Results from damage to brain regions more closely related with declarative and episodic memory (temporal lobe and prefrontal cortex)
  • Damage from blow to the head, stroke, tumor, hypoxia, chronic alcoholism
21
Q

Cognitive deficits post traumatic brain injury

A
  • Attention
  • Information processing speed
  • Executive functioning
22
Q

Physical deficits post traumatic brain injury

A
  • Coordination
  • Fatigue easily
  • Limb dysfunction
  • Speech difficulty
  • Sensory loss
23
Q

Behavioural & emotional deficits post traumatic brain injury

A
  • Sleep disturbance
  • Personality change
  • Irritability
  • Depression
  • PTSD
24
Q

Deficits post traumatic brain injury in children

A
  • Cognitive: Attention, info processing speed, emerging executive functioning, academic difficulties
  • Physical: Coordination, fatigue, limb dysfunction, sensory loss, change in handedness
  • Behavioral and emotional: Sleep disturbance, irritability, social skills, ADHD
25
Q

Factors affecting recovery from traumatic brain injury

A
  • Age: later injury (in life), less vulnerable the brain
  • Genetic make-up
  • Number of prior TBIs
  • Severity of injury
  • Cognitive reserve (education, IQ)
  • Mental health
26
Q

Wernicke’s encephalopathy

A
  • Reversible dementia
  • Characterized by any 2 of the following: Dietary deficiency; eye related signs; cerebellar dysfunction (balance); altered mental state/mild memory impairment
  • Typically caused by excessive alcohol consumption
  • Thiamine (vitamin B1) deficiency
27
Q

Korsakoff’s syndrome

A
  • Partially reversible dementia
  • Anterograde and retrograde amnesia, gait difficulties
  • Linked to long term alcohol abuse
  • Impaired anterograde and partial retrograde memory; disorientation; confabulation; executive dysfunction
28
Q

Parkinson’s disease dementia

A

• Distinguishing features

  • Masked facies (facial expressions)
  • Attention deficits
  • Slowed processing speed
  • Executive dysfunction
  • Bradykinesia – slowed movement
  • Bradyphrenia – slowed thinking
  • Chief complaints – processing speed, executive functioning, attention
  • Movement – tremors
29
Q

Huntington’s disease

A
  • Neurodegenerative disease
  • Movement: Choreic movements – quick involuntary movement of feet and hand (comparable to dancing)
  • Defining features: executive dysfunction, psychiatric symptoms
  • Disease will eventually progress to dementia

• Primary complaints

  • Psychiatric features
  • Difficulty with coordination and balance
  • Visuospatial difficulties
  • Poor articulation and low volume (hypophonia)
30
Q

Lewy-body dementia

A

• Chief complaints: disproportionate visuo-constructional difficulties

  • Pathology: Lewy bodies (abnormal aggregates of protein created in nerve cells in Parkinson’s disease)
  • Starts in cortical regions and moves to sub-cortical regions

• Neuropsychological profile

  • Visual hallucinations
  • Disproportionate visuospatial impairment
  • Fluctuations in cognition
  • Fronto subcortical profile – impaired executive function, apathy and impulsivity
31
Q

Vascular cognitive impairment

A

• Patchy profile – inconsistent deficits (good on some and bad on others that tap the same skill)
• Low mood
• Symptoms depend on brain region affected
• Onset: sudden or gradual
• Progression: step wise
• General structural changes: white matter changes
• General features:
- Attention, processing speed, executive functioning, mood
- Motor symptoms – depending on where damage has been

Psychology (25 decks)

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