NYKN Flashcards
Orbitofrontal syndrome
Socially inappropriate behavior, echopraxia, utilization behaviour (reaching out and using stuff that’s not yours)
Orbitofrontal area function
Voluntary action, decision making, socially appropriate behavior
Dorsolateral frontal/convexity syndrome
Poor attention, motor programming, and immediate recall.
Test for dorsolateral abnormalities
Wisconsin card sorting test
Function of dorsolateral frontal area
Involved with executive functions, working memory, and selective attention.
Medial frontal cortex function
mediates motivated behavior, such as initiation of movement or speech.
Medial frontal cortex syndrome
Amotivation, apathy, and akinesis. Akinetic mutism can be seen in bilateral lesions.
Patients can be incontinent and only eat or drink when fed.
Broca’s aphasia location
Posterior inferior frontal gurus
Kluver Bucy syndrome
Lesion: Bilateral temporal lesions involving the amygdala.
Exam: Hypermetamorphosis (urge to touch everything), compulsive eating, and hypersexuality.
Prosopagnosia or visual for agnosia
Failure to identify objects and faces by visual identification.
Note: may be able to do so by voice.
Capgras delusion
Lesion: Fusiform gyrus; occipito-temporal cortex.
Exam: Variant of prosopagnosia in which the patient believes that a friend, spouse, or a close family member has been replaced by an impostor.
Apperceptive prosopagnosia
Lesion: right occipital-temporal area
Exam: Impaired object recognition. They are unable to recognize faces. However, they may be able to recognize people based on non-face clues (i.e. clothing, skin color, or voice).
Associative prosopagnosia
Lesion: Right anterior temporal area, more often bilateral.
Exam: Impaired object identification. Can copy images but not able to identify an image.
Wernickes aphasia location
Lesion: Superior temporal gyrus.
Gerstmann’s syndrome area
Lesion: Dominant inferior parietal lobe, AKA dominant angular and supramarginal gyrus of the parietal lobe.
Gerstmann’s syndrome exam
Exam: agraphia, acalculia, finger agnosia, and left/right confusion
What to expect with a lesion to the non dominant parietal lobe
Exam:
Anosognosia (unaware of deficit or illness)
Sensory or receptive aprosodia (Impaired ability to perceive emotions in others)
Hemineglect
Dressing apraxia
Balint’ syndrome location
bilateral parietal-occipital lobes
Balint’s syndrome exam
Exam: (triad)
Optic ataxia: the inability to move the hand properly to perform voluntary tasks. Visually-guided hand movements are impaired.
Oculomotor apraxia: the inability to voluntarily fixate eyes to specific locations.
Simultagnosia: the inability to focus on multiple objects.
Pathophysiology of Balint’s syndrome
Watershed infarcts, multiple embolic strokes, or PRES.
Anton syndrome
Cortical blindness (the patient has true blindness, but they deny the presence of this blindness). Patients will often confabulate in response. For example, if asked to identify the color of something, rather than saying “I can’t see,” they may say “It’s blue.”
Anton syndrome location
Bilateral posterior cerebral artery territory infarction. Can also be seen with PRES.
Achromatopsia
Lesion: Inferior lip of the occipital lobe, often bilateral.
Could also present from a lesion to the thalamus.
Exam: Colorblindness
Lesion to the anterior cingulate cortex
Apathy
Bilateral: akinesis and mutism
Alexia without agraphia lesion
Lesion: Splenium of the corpus callosum and unilateral occipital lobe.
Alexia without agraphia
Exam: Inability to read, but with retained ability to write.
Can be seen after a unilateral posterior cerebral artery stroke.
Limb kinetic apraxia
Inability to perform tasks when asked (i.e. unable to brush hair when given a brush).
Location for limb kinetic apraxia
Anterior corpus collosum
Charles Bonnet Syndrome
Seen in patients who have severe vision loss secondary to a variety of pathologies (stroke, macular degeneration, etc.)
Exam: Complex visual hallucinations without other psychopathology, and with the self-awareness that the hallucinations are not real.
Geschwind syndrome
controversial disorder thought to occur in some patients with temporal lobe epilepsy.
Some researchers question whether it actually exists.
Presents as a personality syndrome with hypergraphia (compulsive writing), hyper-religiosity, and atypical sexuality (usually hyposexuality).
Alien hand syndrome locations
Frontal Variant:
Dominant hemisphere lesion of the supplementary motor area or medial prefrontal cortex.
Presents with the right hand impulsively grabbing, groping, and manipulating objects. Also can have utilization behavior.
Usually follows an ACA stroke
Callosal Variant:
Commonly due to callosal hemorrhage, demyelination, or surgery.
Often has “intermanual conflict” (antagonizing movements of the two hands).
Often there are other disconnection symptoms present like apraxia, agraphia, or alexia.
Posterior variant:
Secondary to a non-dominant parietal lobe (posterior postcentral gyrus) lesion.
Associated with a strong feeling of estrangement from the affected limb, and abnormal posturing as well as “levitation” of the limb.
This variant is the one most commonly caused by corticobasal degeneration, Creutzfeld-Jakob disease, or stroke.
Pupil size in serotonin syndrome
Dilated
Reflexes in serotonin syndrome vs neuroleptic malignant
Serotonin - hyper
Neuroleptic - hypo
Anti GQ1b associated with what syndrome
Miller Fisher
Treatment for acute dystonia
Benadryl and benztropine
Neuropathy associated with metals/minerals
Copper deficiency and zinc toxicity
Brain tumor associated with IDH mutation of 1p/19q co-deletion
Central neurocytoma
Treatment of cerebral aspergillosis
Voriconizole
GBA gene associated with Gaucher’s disease is also associated with
Parkinson’s
HTT gene
Huntington’s
APP, APOE, PSEN1 and 2 associated with
Alzheimer’s
SNCA or COQ2 associated with
MSA
SNM1 SNM2 associated with
Spinal muscle atrophy
ATP7B and PRNP associated with
Wilson’s disease
Posterior limb of the internal capsule supplied by which artery
Anterior choroidal
Anterior limb of internal capsule supplied by
ACA via the recurrent artery of Huebner
Nerve roots effected by the cauda equine
L3-S5
Patellar reflex
L3/L4
Branch of the PCA that causes pure sensory stroke
Thalamo geniculate artery
Anatomical variant of thalamo-geniculate artery
Artery of Percheron
Nucleus ambiguous location
Ventrolateral medulla
Injury to the nucleus ambiguous
Dysphaghia, decreased gag reflex, hoarseness
Child with progressive hemiparesis and focal seizures
Rasmussen’s encephalitis
