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183 Cards in this Set
- Front
- Back
Abulia
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Dorsolateral prefrontal syndrome
Diminished spontaneity, verbal output (mutism), and motor behavior (including akinesia) Personality changes Lack of ability to plan or sequence; Working memory deficits Perseveration (repetition of response without a stimulus) or impersistence Incontinence Impaired attentional capacity Anosmia (loss of ability to smell) |
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Dorsolateral prefrontal syndrome
Diminished spontaneity, verbal output (mutism), and motor behavior (including akinesia) Personality changes Lack of ability to plan or sequence; Working memory deficits Perseveration (repetition of response without a stimulus) or impersistence Incontinence Impaired attentional capacity Anosmia (loss of ability to smell) |
Abulia
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Achromatopsia
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Cortical color blindness; bilateral lesion of WHAT stream
Can’t ID or match colors, but can recall colors of familiar objects |
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Cortical color blindness; bilateral lesion of WHAT stream
Can’t ID or match colors, but can recall colors of familiar objects |
Achromatopsia
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ADHD
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School-aged children; genetic component, 5X more common in males
Hyperactivity, impaired attention, impulsivity Reduced activity in prefrontal cortex and basal ganglia Genetic linkage suggests abnormal dopamine receptor/transporter/enzymes Higher incidence in kids exposed to alcohol or tobacco in utero Treated with stimulants to increase dopamine and NE levels in PFC (prefrontal cortex) |
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School-aged children; genetic component, 5X more common in males
Hyperactivity, impaired attention, impulsivity Reduced activity in prefrontal cortex and basal ganglia Genetic linkage suggests abnormal dopamine receptor/transporter/enzymes Higher incidence in kids exposed to alcohol or tobacco in utero Treated with stimulants to increase dopamine and NE levels in PFC (prefrontal cortex) |
ADHD
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Agnosia
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No higher order sensory processing → inability to place significance on incoming sensation
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No higher order sensory processing → inability to place significance on incoming sensation
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Agnosia
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Agraphia
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Writing impairment; often occurs with aphasia
Can occur in isolation with lesion of inferior parietal lobe of dominant hemisphere |
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Writing impairment; often occurs with aphasia
Can occur in isolation with lesion of inferior parietal lobe of dominant hemisphere |
Agraphia
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AION
Anterior Ischemic Optic Neuropathy |
Impaired blood supply to optic n.; common cause of sudden vision loss in pts over 50
Risk factors: diabetes, hypertension, elevated cholesterol |
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Impaired blood supply to optic n.; common cause of sudden vision loss in pts over 50
Risk factors: diabetes, hypertension, elevated cholesterol |
AION
Anterior Ischemic Optic Neuropathy |
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Akinetopsia
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“Motion blindness”; bilateral lesion of WHERE stream
Does not affect visual ID of shapes, objects, or faces; Can still detect tactile movement |
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“Motion blindness”; bilateral lesion of WHERE stream
Does not affect visual ID of shapes, objects, or faces; Can still detect tactile movement |
Akinetopsia
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Alexia
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Reading impairment
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Reading impairment
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Alexia
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Alexia with agraphia
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Lesion in dominant parietal lobe – angular gyrus
Aphasia may be limited to dysnomia and paraphasias |
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Lesion in dominant parietal lobe – angular gyrus
Aphasia may be limited to dysnomia and paraphasias |
Alexia with agraphia
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Alexia without agraphia
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PCA lesion in dominant occipital cortex into corpus callosum
Contralateral visual field deficit Disconnection syndrome: between intact R visual areas and L hemisphere language centers Can’t decode language-related visual information Can still comprehend auditory speech and spoken and written language |
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PCA lesion in dominant occipital cortex into corpus callosum
Contralateral visual field deficit Disconnection syndrome: between intact R visual areas and L hemisphere language centers Can’t decode language-related visual information Can still comprehend auditory speech and spoken and written language |
Alexia without agraphia
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Alien hand syndrome
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Damage in supplementary motor area → disconnection syndrome
Movement of contralateral arm not under voluntary control |
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Damage in supplementary motor area → disconnection syndrome
Movement of contralateral arm not under voluntary control |
Alien hand syndrome
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Altitudinal scotoma
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Lesion of the upper or lower branch of the retinal artery
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Lesion of the upper or lower branch of the retinal artery
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Altitudinal scotoma
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Alzheimer’s disease
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Neurodegeneration: B-amyloid plaques & tau tangles – temporal lobe (hippocampus)
Progressive Memory affected first and most seriously Disorientation, disinhibition, behavioral changes, aphasia Final stages: loss of ability to walk, eat, etc… without assistance Late onset sporadic: interplay of genetic and environment APOE (transports cholesterol): APOEe4 = “risk factor”, APOEe2 = protective Experience: Higher level of education and more physical activity = reduced risk Early onset familial: autosomal dominant (1-5% of cases) Onset before 65 Mutatations IDed that affect processing of amyloid precursor protein |
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Neurodegeneration: B-amyloid plaques & tau tangles – temporal lobe (hippocampus)
Progressive Memory affected first and most seriously Disorientation, disinhibition, behavioral changes, aphasia Final stages: loss of ability to walk, eat, etc… without assistance Late onset sporadic: interplay of genetic and environment APOE (transports cholesterol): APOEe4 = “risk factor”, APOEe2 = protective Experience: Higher level of education and more physical activity = reduced risk Early onset familial: autosomal dominant (1-5% of cases) Onset before 65 Mutatations IDed that affect processing of amyloid precursor protein |
Alzheimer’s disease
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Amaurosis fugax
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“Fleeting darkness”; monocular vision loss for ~10 min; warning for retinal or cerebral infarct
Cause: stenosis of ipsilteral internal carotid → transient occlusion of the retinal artery |
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“Fleeting darkness”; monocular vision loss for ~10 min; warning for retinal or cerebral infarct
Cause: stenosis of ipsilteral internal carotid → transient occlusion of the retinal artery |
Amaurosis fugax
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Anomia
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Difficulty with naming, may include paraphasias; may be category specific
Associated with limited damage to temporal lobe in WHAT stream |
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Difficulty with naming, may include paraphasias; may be category specific
Associated with limited damage to temporal lobe in WHAT stream |
Anomia
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Anosognosia
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Unaware of functional deficits
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Unaware of functional deficits
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Anosognosia
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Anton’s syndrome
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Diseases of basilar artery → bilateral PCA ischemia or infarcts (bilateral lesion of primary visual cortex) → cortical blindness
Patient is not aware they are blind (anosognosia) |
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Diseases of basilar artery → bilateral PCA ischemia or infarcts (bilateral lesion of primary visual cortex) → cortical blindness
Patient is not aware they are blind (anosognosia) |
Anton’s syndrome
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Aphasia
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Partial or complete loss of language abilities, often without loss of cognition, sensation, or ability to move the muscles used in speech
Common cause: cerebral infarct of left MCA |
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Partial or complete loss of language abilities, often without loss of cognition, sensation, or ability to move the muscles used in speech
Common cause: cerebral infarct of left MCA |
Aphasia
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Aphasias in bilinguals
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Languages learned earlier and more fluently are less affected
Equal deficits if languages learned at the same time |
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Languages learned earlier and more fluently are less affected
Equal deficits if languages learned at the same time |
Aphasias in bilinguals
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Aphemia
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Foreign accent syndrome
Apraxia of speech articulation, sparing written language Results from small lesion in operculum of dominant hemisphere |
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Foreign accent syndrome
Apraxia of speech articulation, sparing written language Results from small lesion in operculum of dominant hemisphere |
Aphemia
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Apraxia
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Loss of ability to correctly perform a motor response in the absence of damage to language, primary motor, or cerebellar pathways
Exhibited in about 1/3 of aphasias |
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Loss of ability to correctly perform a motor response in the absence of damage to language, primary motor, or cerebellar pathways
Exhibited in about 1/3 of aphasias |
Apraxia
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Auditory disorders
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Perception of spoken language affected; reading and writing spared
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Perception of spoken language affected; reading and writing spared
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Auditory disorders
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Autism spectrum disorders
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Strong genetic component – twins & siblings; Some variants X-linked – 4X higher in males
Family linkage studies implicate genes for neural development (neuroligins & neurexins) Some cases documented de novo gene deletions and duplications relative to parents Evidence for abnormal structure/function: Brain overgrowth in early development could interfere with development of connection between areas; Growth arrest later on is possible because many autistic adults have reduced volume in specific cortical areas; Pyramidal cells reduced in size and dendritic branching |
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Strong genetic component – twins & siblings; Some variants X-linked – 4X higher in males
Family linkage studies implicate genes for neural development (neuroligins & neurexins) Some cases documented de novo gene deletions and duplications relative to parents Evidence for abnormal structure/function: Brain overgrowth in early development could interfere with development of connection between areas; Growth arrest later on is possible because many effected adults have reduced volume in specific cortical areas; Pyramidal cells reduced in size and dendritic branching |
Autism spectrum disorders
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Balint’s syndrome
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Usually from MCA-PCA watershed (systemic hypotension with internal carotid disease)
Bilteral lesion of WHERE stream; triad of symptoms Simultagnosia: Can recognize and describe details, but can’t perceive visual scene as a whole Optic ataxia: Can’t use visual info to accurately coordinate actions – NOT cerebellar ataxia; People can still point using auditory and other cues Ocular apraxia: difficulty voluntarily directing gaze toward periphery through saccades May coexist with inferior quadrantanopia, aphasia, or hemineglect |
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Usually from MCA-PCA watershed (systemic hypotension with internal carotid disease)
Bilteral lesion of WHERE stream; triad of symptoms Simultagnosia: Can recognize and describe details, but can’t perceive visual scene as a whole Optic ataxia: Can’t use visual info to accurately coordinate actions – NOT cerebellar ataxia; People can still point using auditory and other cues Ocular apraxia: difficulty voluntarily directing gaze toward periphery through saccades May coexist with inferior quadrantanopia, aphasia, or hemineglect |
Balint’s syndrome
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Bitemporal hemianopia
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Bilateral lateral visual field
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Bilateral lateral visual field defect
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Bitemporal hemianopia
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Broca’s aphasia
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Expressive or motor aphasia
Lesion of left superior MCA; accompanied by R hemiparesis of arm and face Telegraphic or stuttering style of speech (unless over-memorized), but still makes sense Anomia; reading and writing also impaired Impaired repetition; comprehension generally good – can carry out verbal instructions Patient is frustrated and aware of deficits |
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Expressive or motor aphasia
Lesion of left superior MCA; accompanied by R hemiparesis of arm and face Telegraphic or stuttering style of speech (unless over-memorized), but still makes sense Anomia; reading and writing also impaired Impaired repetition; comprehension generally good – can carry out verbal instructions Patient is frustrated and aware of deficits |
Broca’s aphasia
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Capgras syndrome
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Patient believes family and friends have been replaced by imposters
Disconnect between limbic system and “face” area of occipitotemporal cortex (WHAT) “Imposters” “logically” explains lack of emotional response Can recognize by voice alone because limbic-auditory connection is okay |
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Patient believes family and friends have been replaced by imposters
Disconnect between limbic system and “face” area of occipitotemporal cortex (WHAT) “Imposters” “logically” explains lack of emotional response Can recognize by voice alone because limbic-auditory connection is okay |
Capgras syndrome
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Color anomia/agnosia
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Damage to visual cortex of dominant hemisphere + splenium of corpus callosum
May be seen with alexia w/o agraphia, usually with contralateral hemianopsia Can’t verbally name color because of disconnection between visual and language areas |
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Damage to visual cortex of dominant hemisphere + splenium of corpus callosum
May be seen with alexia w/o agraphia, usually with contralateral hemianopsia Can’t verbally name color because of disconnection between visual and language areas |
Color anomia/agnosia
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Conceptual Hemineglect
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Anosognosia unaware of deficit
Anosodiaphoria unaware but unconcerned Hemiasomatognosia denial of neglected half of body or a portion o fit |
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These are examples of ____ hemineglect.
Anosognosia unaware of deficit Anosodiaphoria unaware but unconcerned Hemiasomatognosia denial of neglected half of body or a portion o fit |
Conceptual Hemineglect
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Conduction aphasia
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A disconnection sydrome
Damage to arcuate fasciculus, sparing Broca’s and Wernicke’s areas Impaired repetition – responds with related words Normal fluency and comprehension; impaired naming, paraphasic errors |
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A disconnection sydrome
Damage to arcuate fasciculus, sparing Broca’s and Wernicke’s areas Impaired repetition – responds with related words Normal fluency and comprehension; impaired naming, paraphasic errors |
Conduction aphasia
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Dementia with Lewy bodies
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*aka corticobasal degeneration
Onset after 60; More frequent in males; Familial risk factor Parkinsonism Visual hallucination: could be an early symptom, distinguishes from other dementias Cognitive problems: confusion, fluctuating attention, disorganized speech, executive dysfunction, visual-spatial impairment (apraxia) Unlike Alzheimer’s: memory deficits less prominent REM behavioral sleep disorder (may precede other symptoms by several years) Diagnosis by process of elimination Moderately rapid decline → death within 8 years Neurodegeneration due to accumulation of alphasynuclein in substantia nigra and cortex |
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*aka corticobasal degeneration
Onset after 60; More frequent in males; Familial risk factor Parkinsonism Visual hallucination: could be an early symptom, distinguishes from other dementias Cognitive problems: confusion, fluctuating attention, disorganized speech, executive dysfunction, visual-spatial impairment (apraxia) Unlike Alzheimer’s: memory deficits less prominent REM behavioral sleep disorder (may precede other symptoms by several years) Diagnosis by process of elimination Moderately rapid decline → death within 8 years Neurodegeneration due to accumulation of alphasynuclein in substantia nigra and cortex |
Dementia with Lewy bodies
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Dichotic listening
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Present separate stimuli to each ear to determine dominance
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Present separate stimuli to each ear to determine dominance
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Dichotic listening
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Disconnection syndromes
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Lesion in white matter affects communication between areas
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Lesion in white matter affects communication between areas
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Dissconnection syndrome
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Disinhibited prefrontal syndrome
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Orbitomedial prefrontal syndrome
Impulsive, stimulus-driven behavior Diminished social insight; inappropriate humor Confabulation Emotional lability Phineas Gage: No motor or speech deficits, Perseveration (repetition of response without a stimulus) or impersistence Incontinence with a lack of concern Impaired attentional capacity Anosmia (loss of ability to smell) |
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Orbitomedial prefrontal syndrome
Impulsive, stimulus-driven behavior Diminished social insight; inappropriate humor Confabulation Emotional lability Phineas Gage: No motor or speech deficits, Perseveration (repetition of response without a stimulus) or impersistence Incontinence with a lack of concern Impaired attentional capacity Anosmia (loss of ability to smell) |
Disinhibited prefrontal syndrome
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Dissection
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Small tear in vessel allows blood to burrow into vessel wall – flap protrudes into vessel lumen – thrombus forms and possible embolus
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Small tear in vessel allows blood to burrow into vessel wall – flap protrudes into vessel lumen – thrombus forms and possible embolus
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Dissection
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Down’s syndrome
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Mental retardation
Extra copy of chromosome 21 Over-expression of DSCAM, cell-adhesion molecule promoting neuronal differentiation and axonal growth |
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Mental retardation
Extra copy of chromosome 21 Over-expression of DSCAM, cell-adhesion molecule promoting neuronal differentiation and axonal growth |
Down’s syndrome
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Dysarthria & Aphemia
motor or sensory problems? |
Exclusively motor dysfunctions
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Exclusively motor dysfunctions
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Dysarthria & Aphemia
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Dyslexia
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Developmental with strong genetic component; mainly affects reading
Normal intelligence and spoken language Phonological hypothesis: trouble learning phonetics, less common in less phonetically complex languages (ex: Japanese) Early intervention can help “rewire” language areas Family studies have IDed polymorphisms in genes important for neuronal migration, presumably affecting connections between visual and language centers ROBO1 – important for development of commissural connections DCDC2 – expressed at high levels in language areas Subtle abnormalities indicate expression levels or pattern of expression affected by mutation, not complete loss |
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Developmental with strong genetic component; mainly affects reading
Normal intelligence and spoken language Phonological hypothesis: trouble learning phonetics, less common in less phonetically complex languages (ex: Japanese) Early intervention can help “rewire” language areas Family studies have IDed polymorphisms in genes important for neuronal migration, presumably affecting connections between visual and language centers ROBO1 – important for development of commissural connections DCDC2 – expressed at high levels in language areas Subtle abnormalities indicate expression levels or pattern of expression affected by mutation, not complete loss |
Dyslexia
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Embolism
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Something lodges in and occlude a vessel (~1/3 of all strokes)
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Something lodges in and occlude a vessel (~1/3 of all strokes)
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Embolism
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Encephalopathy
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Diffuse brain dysfunction
Acute: metabolic or toxic Hydrocephalus Chronic: dementias, including Alzheimer’s |
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Diffuse brain dysfunction
Acute: metabolic or toxic Hydrocephalus Chronic: dementias, including Alzheimer’s |
Encephalopathy
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Fragile-X
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Mental retardation involving a single gene
Triplet repeat in an RNA-binding protein (FMR1) Associated with immature dendritic morphology |
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Mental retardation involving a single gene
Triplet repeat in an RNA-binding protein (FMR1) Associated with immature dendritic morphology |
Fragile-X
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Frontal lobe degenerative
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Huntington’s
Prefrontal channel: deterioration of cognitive and executive functions Limbic channel: impaired impulse control and socially inappropriate behavior |
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Huntington’s is ____ lobe degeneration
Prefrontal channel: deterioration of cognitive and executive functions Limbic channel: impaired impulse control and socially inappropriate behavior |
Frontal lobe degenerative
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Gerstmann’s syndrome
*aka agraphic alexia or parietal alexia |
Larger lesion of angular gyrus
Severe agraphia and alexia; Acalculia (can’t do math); Right-left disorientation Finger agnosia (can’t distinguish the fingers of the hand) Auditory comprehension and speech are intact |
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Larger lesion of angular gyrus
Severe agraphia and alexia; Acalculia (can’t do math); Right-left disorientation Finger agnosia (can’t distinguish the fingers of the hand) Auditory comprehension and speech are intact |
Gerstmann’s syndrome
*aka agraphic alexia or parietal alexia |
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Global aphasia
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Wernicke’s + Broca’s
Lesion of MCA stem or subcortical damage |
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Wernicke’s + Broca’s
Lesion of MCA stem or subcortical damage |
Global aphasia
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Hemianopia, hemianopsia
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Blindness in ½ of the visual field
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Blindness in ½ of the visual field
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Hemianopia, hemianopsia
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Hemineglect
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Sensation intact, lack of attention to and/or behavior consistent with perception
Usually results from acute lesion in right parietal and/or frontal cortex |
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Sensation intact, lack of attention to and/or behavior consistent with perception
Usually results from acute lesion in right parietal and/or frontal cortex |
Hemineglect
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Hemispatial neglect
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Difficulty orienting body in space and performing tasks with spatial component
Line bisection bisect to right of midline Cancellation tasks only cancel on right side Drawing only draw right side of a scene) Reading and writing only read right words and use ½ of the page to write Failure to orient to objects in space contralateral to the lesion: wash or dress one side of the body, apply make-up to ½ of face, eat food on ½ of the plate |
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Difficulty orienting body in space and performing tasks with spatial component
Line bisection bisect to right of midline Cancellation tasks only cancel on right side Drawing only draw right side of a scene) Reading and writing only read right words and use ½ of the page to write Failure to orient to objects in space contralateral to the lesion: wash or dress one side of the body, apply make-up to ½ of face, eat food on ½ of the plate |
Hemispatial neglect
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Hemorrhage
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Rupture of vessel, bleeding into tissue
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Rupture of vessel, bleeding into tissue
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Hemorrhage
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Homonymous
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Affecting the same part of the visual field of each eye
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Affecting the same part of the visual field of each eye
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Homonymous
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Infarct
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Necrosis by occlusion of blood flow (arterial or venous)
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Necrosis by occlusion of blood flow (arterial or venous)
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Infarct
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Describe infarcts affecting primary visual cortex
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Complete PCA → contralateral homonymous hemianopsia
Smaller infarcts → smaller corresponding areas of visual loss Macular sparing is due to collateral MCA flow to occipital pole |
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Complete PCA → contralateral homonymous hemianopsia
Smaller infarcts → smaller corresponding areas of visual loss Macular sparing is due to collateral MCA flow to occipital pole |
Infarct affecting primary visual cortex
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Ischemia
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Deficiency of blood due to functional constriction or obstruction of a vessel
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Deficiency of blood due to functional constriction or obstruction of a vessel
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Ischemia
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Hemorrhage
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Rupture of vessel, bleeding into tissue
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Rupture of vessel, bleeding into tissue
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Hemorrhage
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Homonymous
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Affecting the same part of the visual field of each eye
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Affecting the same part of the visual field of each eye
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Homonymous
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Infarct
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Necrosis by occlusion of blood flow (arterial or venous)
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Necrosis by occlusion of blood flow (arterial or venous)
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Infarct
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Infarct affecting primary visual cortex
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Complete PCA → contralateral homonymous hemianopsia
Smaller infarcts → smaller corresponding areas of visual loss Macular sparing is due to collateral MCA flow to occipital pole |
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Complete PCA → contralateral homonymous hemianopsia
Smaller infarcts → smaller corresponding areas of visual loss Macular sparing is due to collateral MCA flow to occipital pole |
Infarct affecting primary visual cortex
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Ischemia
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Deficiency of blood due to functional constriction or obstruction of a vessel
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Deficiency of blood due to functional constriction or obstruction of a vessel
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Ischemia
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Ischemic core
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Actual area of severely reduced blood flow; loss of oxygen and glucose, depletion of energy stores, direct damage to neurons and glia
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Actual area of severely reduced blood flow; loss of oxygen and glucose, depletion of energy stores, direct damage to neurons and glia
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Ischemic core
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Ischemic penumbra
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Moderately ischemic area with some collateral blood supply; area of secondary damage if reperfusion delayed
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Moderately ischemic area with some collateral blood supply; area of secondary damage if reperfusion delayed
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Ischemic penumbra
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Lesion of optic chiasm
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→ bitemporal hemianopsia; Common causes: pituitary tumor, aneurysm
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lesion location resulting in bitemporal hemianopsia
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Lesion of optic chiasm
common causes: pituitary tumor, aneurysm |
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LGN lesions
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Caused by tumors, vascular accident
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Lissencephaly
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Mental retardation involving a single gene
One cause is loss of function in reelin, which guides neuronal migration |
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Mental retardation involving a single gene
One cause is loss of function in reelin, which guides neuronal migration |
Lissencephaly
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Mixed transcortical aphasia
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Global aphasia, but with repetition intact
Caused by subcortical damage |
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Global aphasia, but with repetition intact
Caused by subcortical damage |
Mixed transcortical aphasia
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Monocular
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Affecting one eye
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Affecting one eye
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Monocular
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Motor intentional neglect
Hemiakinesia |
No spontaneous use of limbs on contralateral side
But good muscle strength and coordination; Ask pt to raise limbs to test for extinction Difficulty moving toward the side of space they are neglecting |
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No spontaneous use of limbs on contralateral side
But good muscle strength and coordination; Ask pt to raise limbs to test for extinction Difficulty moving toward the side of space they are neglecting |
Motor intentional neglect
Hemiakinesia |
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Multi-infarct dementia
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Onset rapid or stepwise, usually ages 60-75, 10-20% of dementias
Biggest risk factor is high blood pressure Confusion, problems with recent memory, inappropriate affect Often with motor, sensory or other deficits |
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Onset rapid or stepwise, usually ages 60-75, 10-20% of dementias
Biggest risk factor is high blood pressure Confusion, problems with recent memory, inappropriate affect Often with motor, sensory or other deficits |
Multi-infarct dementia
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Optic nerve lesions
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Glaucoma, optic neuritis (related to MS), elevated ICP, tumors → Monocular vision loss
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caused by glaucoma, optic neuritis (related to MS), elevated ICP, tumors
result in monocular vision loss |
Optic nerve lesions
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Optic radiation lesion
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Lower: Inferior MCA infarct; “pie in the sky”
Upper: Superior MCA infarct; “pie on the floor” Both: PCA/MCA watershed infarct (with low BP) → contralateral homonymous hemianopia |
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These are lesions of which structure?
Lower: Inferior MCA infarct; “pie in the sky” Upper: Superior MCA infarct; “pie on the floor” Both: PCA/MCA watershed infarct (with low BP) → contralateral homonymous hemianopia |
Optic radiation lesion
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Optic tract lesions - visual field defect
Also, are they common? |
Homonymous hemianopia.
Uncommon due to blood supply from small branches of several vessels |
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Uncommon due to blood supply from small branches of several vessels
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Optic tract lesions
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Paraphasia
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Unintentional substitution of syllables, words, or phrases
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Unintentional substitution of syllables, words, or phrases
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Paraphasia
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Pick’s disease
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Frontotemporal dementia
Gradual anset ages 35-60, strong genetic component Accumulation of Tau tangles Changes in personality/social behavior, loss of initiative and inhibition Laguage deficits → mutism Memory loss less severe |
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Frontotemporal dementia
Gradual anset ages 35-60, strong genetic component Accumulation of Tau tangles Changes in personality/social behavior, loss of initiative and inhibition Laguage deficits → mutism Memory loss less severe |
Pick’s disease
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Prosopagnosia
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Can’t recognize faces or learn new ones; bilateral lesion of WHAT stream
Can’t integrate, but can ID people with distinguishing features; Can ID by voice or other cues |
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Can’t recognize faces or learn new ones; bilateral lesion of WHAT stream
Can’t integrate, but can ID people with distinguishing features; Can ID by voice or other cues |
Prosopagnosia
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Psych disorders related to diffuse modulatory imbalance
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Schizophrenia
Depression |
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Quadrantinopia with macular sparing
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Retained vision in the center of the visual field due to collateral flow by MCA to the occipital pole
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Retained vision in the center of the visual field due to collateral flow by MCA to the occipital pole
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Quadrantinopia with macular sparing
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Quadrantinopia/opsia
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Blindness in ¼ of the visual field
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Blindness in ¼ of the visual field
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Quadrantinopia/opsia
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Retrochiasmal lesions
visual field defects are ipsilateral or contralateral? |
contralateral homonymous visual field deficits
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→ contralateral homonymous visual field deficits
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Retrochiasmal lesions
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Rett syndrome
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Mental retardation involving a single gene
X-linked dominant with developmental regression in early childhood Mutation in MECP2 – codes for transcriptional repressor that silences methylated genes |
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Mental retardation involving a single gene
X-linked dominant with developmental regression in early childhood Mutation in MECP2 – codes for transcriptional repressor that silences methylated genes |
Rett syndrome
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Schizophrenia
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Language problems due to disorganization of thought processes
Dopamine transmission imbalance in mesocoritcal pathways Believed to be polygenic, neural developmental disorder with late onset 30% incidence in people with deletion in chromosome 22 Mutations in DISC 1, which controls axon guidance and outgrowth Mutations in Neuregulon, an EGF protein – important at several stages in brain development |
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Language problems due to disorganization of thought processes
Dopamine transmission imbalance in mesocoritcal pathways Believed to be polygenic, neural developmental disorder with late onset 30% incidence in people with deletion in chromosome 22 Mutations in DISC 1, which controls axon guidance and outgrowth Mutations in Neuregulon, an EGF protein – important at several stages in brain development |
Schizophrenia
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Scotoma
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Black, dark brown, purplish or white region of visual loss
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Black, dark brown, purplish or white region of visual loss
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Scotoma
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Sensory neglect
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Ignore stimuli in contralateral hemisphere
Sensory extinction: when stimuli presented simultaneously to both sides, only perceived on intact side Visual neglect most common Intact vision demonstrated by presenting stimulus only to the left visual field |
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Ignore stimuli in contralateral hemisphere
Sensory extinction: when stimuli presented simultaneously to both sides, only perceived on intact side Visual neglect most common Intact vision demonstrated by presenting stimulus only to the left visual field |
Sensory neglect
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Sign language and aphasias in deaf
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Sign language uses same areas as spoken language, but usually more bilateral
Left hemisphere damage → syndromes comparable to Broca’s and Wernicke’s Right hemisphere damage → visual-perceptual problems |
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Split-brain patients
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Corpus callosum cut to treat epilepsy; reveals language comprehension in non-dominant hemisphere, even though they can’t speak; confabulation by dominant hemisphere to explain actions of isolated right hemisphere
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Corpus callosum cut to treat epilepsy; reveals language comprehension in non-dominant hemisphere, even though they can’t speak; confabulation by dominant hemisphere to explain actions of isolated right hemisphere
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Split-brain patients
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Sudden and severe attack
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Stroke
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Stroke
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Sudden and severe attack
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Stuttering
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Developmental with strong genetic component (twins); boys less likely to improve
Apparently, abnormal cortical activation patterns during speech initiate motor program before preparation of articulatory code Often situation specific |
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Developmental with strong genetic component (twins); boys less likely to improve
Apparently, abnormal cortical activation patterns during speech initiate motor program before preparation of articulatory code Often situation specific |
Stuttering
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Supranuclear palsy
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Widespread neurodegeneration in midbrain-diencephalon junction
Dementia Parkinsonism Loss of vertical eye movements and wide-eyed stare Rigidity of neck rather than limbs Bradykinesia and frequent falls |
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Widespread neurodegeneration in midbrain-diencephalon junction
Dementia Parkinsonism Loss of vertical eye movements and wide-eyed stare Rigidity of neck rather than limbs Bradykinesia and frequent falls |
Supranuclear palsy
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Thrombus
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Blood clot formed on vessel wall underlying atherosclerotic plaque; causes occlusion
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Blood clot formed on vessel wall underlying atherosclerotic plaque; causes occlusion
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Thrombus
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TIA
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EMERGENCY: indicator of potential stroke; ~10 min; more than 10 min → permanent cell damage; more than 1 hr → distinguishable infarct
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EMERGENCY: indicator of potential stroke; ~10 min; more than 10 min → permanent cell damage; more than 1 hr → distinguishable infarct
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TIA
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Transcortical aphasias
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Often caused by watershed infarcts, also subcortical damage
Repetition intact |
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Often caused by watershed infarcts, also subcortical damage
Repetition intact |
Transcortical aphasias
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Transcortical motor aphasia
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Broca’s, but with repetition intact
ACA-MCA watershed Lesion in connection from Broca’s to prefrontal cortex |
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Broca’s, but with repetition intact
ACA-MCA watershed Lesion in connection from Broca’s to prefrontal cortex |
Transcortical motor aphasia
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Transcortical sensory aphasia
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Wernicke’s, but with repetition intact
MCA-PCA watershed Lesion in connection from Wernicke’s to parietal and temporal lobes |
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Wernicke’s, but with repetition intact
MCA-PCA watershed Lesion in connection from Wernicke’s to parietal and temporal lobes |
Transcortical sensory aphasia
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Wada’s procedure
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Anesthetize hemispheres separately to determine dominance
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Anesthetize hemispheres separately to determine dominance
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Wada’s procedure
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Wernicke’s aphasia
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Receptive or sensory aphasia
Lesion of left inferior MCA; often with contralateral superior quadrantanopia Damage to Wernicke’s area (BA 22) and/or Supramarginal and angular gyrus (BA 39 & 40) Word salad: fluent, effortless speech, but nonsensical Anomia; reading and writing also impaired; Paraphasia Impaired repititon Anosognosia |
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Receptive or sensory aphasia
Lesion of left inferior MCA; often with contralateral superior quadrantanopia Damage to Wernicke’s area (BA 22) and/or Supramarginal and angular gyrus (BA 39 & 40) Word salad: fluent, effortless speech, but nonsensical Anomia; reading and writing also impaired; Paraphasia Impaired repititon Anosognosia |
Wernicke’s aphasia
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inability to handle stress → weakened prefrontal cortex functions → overactivation of limbic circuits; Treatment balances serotonergic and noradrenergic systems
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depression
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depression
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inability to handle stress → weakened prefrontal cortex functions → overactivation of limbic circuits; Treatment balances serotonergic and noradrenergic systems
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