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““Neurological DisordersNeurological Disorders””

Human Neuropsychology (486 / 686)Human Neuropsychology (486 / 686)

Lecture Chapter 26Lecture Chapter 26

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The Neurological ExaminationThe Neurological ExaminationPatient HistoryPatient History

Patient and family background and disease historyPatient and family background and disease historyObservation of behavior and state of awarenessObservation of behavior and state of awarenessSimple tests of memory and speechSimple tests of memory and speech

The Physical ExaminationThe Physical ExaminationHead and body size, Blood pressureHead and body size, Blood pressureVarious reflexesVarious reflexesSmell and taste, sensation and hearingSmell and taste, sensation and hearingSensitivity to lightSensitivity to lightMuscular strengthMuscular strengthObject recognition, speech repetitionObject recognition, speech repetition

Vascular DisordersVascular Disorders

Cerebral vascular accident (CVA) aka Cerebral vascular accident (CVA) aka Stroke: Stroke: sudden appearance of neurological sudden appearance of neurological symptoms resulting from disruption of blood flow symptoms resulting from disruption of blood flow to the brainto the brain

Mild to severeMild to severe

Ischemia – lack of blood supplyIschemia – lack of blood supply

Causes: Thrombosis, Embolism, Cerebral Arteriosclerosis, Cerebral Vascular Causes: Thrombosis, Embolism, Cerebral Arteriosclerosis, Cerebral Vascular Insufficiency (transient ischemia)Insufficiency (transient ischemia)

Migraine stroke - Appears as a transient ischemic attackMigraine stroke - Appears as a transient ischemic attackSymptoms: Symptoms: Impaired sensory function, Numbness, Difficulty moving, AphasiaImpaired sensory function, Numbness, Difficulty moving, Aphasia

Cerebral Hemorrhage – bleedingCerebral Hemorrhage – bleeding

most common cause high blood pressuremost common cause high blood pressure

Vascular DisordersVascular Disorders

Angiomas - Angiomas - Collection of Collection of abnormal blood abnormal blood vessels vessels

Vascular DisordersVascular Disorders

Aneurysms - Aneurysms - Vascular dilationVascular dilation

Angiomas -Angiomas -Arteriovenous Arteriovenous

MalformationMalformation

TreatmentsTreatmentsDrug therapiesDrug therapiesAnticoagulants, blood Anticoagulants, blood

pressure pressure meds,steroids meds,steroids

SurgeriesSurgeries

Traumatic Brain InjuriesTraumatic Brain Injuries

Open Head Injury – penetrating wounds,Open Head Injury – penetrating wounds,

deficits specific to injury site, greatest risk of deficits specific to injury site, greatest risk of infectioninfection

Closed Head Injury – Closed Head Injury –

forces that cause damage: coup, forces that cause damage: coup, countercoup, twisting and shearing, countercoup, twisting and shearing, bleeding and edemableeding and edema

Closed-Head InjuriesClosed-Head Injuries

ComaComa

Behavioral effectsBehavioral effects

General complaintsGeneral complaints

Risk for future head injuryRisk for future head injury

Cumulative effects Cumulative effects

Behavioral AssessmentBehavioral Assessment

Glasgow Coma Glasgow Coma ScaleScale

Behavioral AssessmentBehavioral Assessment

Post-Traumatic Post-Traumatic Amnesia (PTA)Amnesia (PTA)

EpilepsyEpilepsy

Three common Three common symptomssymptoms

Diagnosed with Diagnosed with EEGEEG

Types of Seizures:Types of Seizures: Focal Focal

Jacksonian, Complex partialJacksonian, Complex partial GeneralizedGeneralized

Grand Mal, Petit MalGrand Mal, Petit Mal Akinetic and MyoclonicAkinetic and Myoclonic

Anticonvulsant drugsAnticonvulsant drugs SurgerySurgery

Treatment for Epilepsy:Treatment for Epilepsy:

TumorsTumors

Benign vs MalignantBenign vs Malignant Encapsulated vs InfiltratingEncapsulated vs Infiltrating

Types:Types:

Gliomas, Meningiomas, MetastaticGliomas, Meningiomas, Metastatic

Treatment:Treatment:

Surgery, Radiation, ChemotherapySurgery, Radiation, Chemotherapy

Gliomas:Gliomas:

oligodendrogliomaoligodendroglioma

astrocytomaastrocytoma

ependymomaependymoma

MenigiomasMenigiomas

Metastatic Metastatic tumorstumors

From Lung cancer

From skin cancer

Headaches: MigraineHeadaches: MigraineClassic migraineClassic migraine

Common migraineCommon migraineCluster headacheCluster headacheHemiplegic and ophthalmologic migraineHemiplegic and ophthalmologic migraineTreatment: Specific drugs to prevent and Treatment: Specific drugs to prevent and

control pain e.g. topamax, ergotaminecontrol pain e.g. topamax, ergotamine

Other HeadachesOther Headaches

Neurological disease relatedNeurological disease relatedCauses: tumor, head trauma,infections, vascular malformation, Causes: tumor, head trauma,infections, vascular malformation, hypertensionhypertensiontreatment: treat the causetreatment: treat the cause

Muscle-contraction headaches (Muscle-contraction headaches (tension)tension)

treatment: Analgesics, treatment: Analgesics, Muscle relaxants, tranquilizers, Muscle relaxants, tranquilizers, posture improvement, reduce stressposture improvement, reduce stress

Nonmigrainous vascular headachesNonmigrainous vascular headachesCauses: Fever, anoxia, anemia, high altitude, physical effort, Causes: Fever, anoxia, anemia, high altitude, physical effort, hypoglycemia, food, or chemical agentshypoglycemia, food, or chemical agents

InfectionsInfectionsInterfere with blood supply, Interfere with blood supply, Disrupt glucose or Disrupt glucose or oxygen metabolism, Alter cell membranes, Form oxygen metabolism, Alter cell membranes, Form pus, Edemapus, Edema

Types:Types: Viruses – neurotropic, pantropicViruses – neurotropic, pantropic

treatment: Difficult to treat; no antidotetreatment: Difficult to treat; no antidote Bacteria – Meningitis, Brain abscessesBacteria – Meningitis, Brain abscesses

treatment: Antibiotics, Drainage treatment: Antibiotics, Drainage

Mycotic Infections – fungusMycotic Infections – fungus Parasitic InfectionsParasitic Infections – Amebiasis,Malaria – Amebiasis,Malaria

No satisfactory treatment, AntibioticsNo satisfactory treatment, Antibiotics

Motor Neurons and the Spinal CordMotor Neurons and the Spinal Cord Myasthenia GravisMyasthenia Gravis

PoliomyelitisPoliomyelitis

Multiple SclerosisMultiple Sclerosis

ParaplegiaParaplegia

Brown-SBrown-Sééquard Syndromequard Syndrome

HemiplegiaHemiplegia

1. Moran and Desimone showed that monkey 1. Moran and Desimone showed that monkey neurons responded selectively to specific neurons responded selectively to specific stimuli in their visual fields:stimuli in their visual fields:

a. after reward traininga. after reward training

b. when the stimulus was presented to the right b. when the stimulus was presented to the right visual hemifieldvisual hemifield

c. when the stimulus was presented to the left c. when the stimulus was presented to the left visual hemifieldvisual hemifield

d. when the stimulus was a particular colord. when the stimulus was a particular color

2. Which of the following processes are 2. Which of the following processes are necessary prerequisites of consciousness?necessary prerequisites of consciousness?

  

a. attention and perceptiona. attention and perception

b. working memoryb. working memory

c. arousal c. arousal

d. all of these processes are necessaryd. all of these processes are necessary

3. Dendrite growth differs from axonal 3. Dendrite growth differs from axonal growth in that:growth in that:

a. axons grow faster than dendrites in order a. axons grow faster than dendrites in order to play a role in shaping dendritic growthto play a role in shaping dendritic growth

b. axons grow faster than dendrites in order b. axons grow faster than dendrites in order to reach a larger maximum sizeto reach a larger maximum size

c. dendrite grow faster than axons in order to c. dendrite grow faster than axons in order to play a role in shaping axonal growthplay a role in shaping axonal growth

d. dendrite grow faster than axons in order to d. dendrite grow faster than axons in order to reach a larger maximum sizereach a larger maximum size

4. After a series of higher than normal 4. After a series of higher than normal stimulations followed by a rest period, a stimulations followed by a rest period, a baseline stimulation to a neuron elicits a baseline stimulation to a neuron elicits a greater excitatory post synaptic potential greater excitatory post synaptic potential from another neuron that receives it’s from another neuron that receives it’s projections. This phenomenon is known as: projections. This phenomenon is known as:

  

a. kindlinga. kindling

b. long-term potentiationb. long-term potentiation

c. ischemiac. ischemia

d. synaptogenesisd. synaptogenesis

5. Countercoup damage is the result of:5. Countercoup damage is the result of:

a. aneurysma. aneurysm

b. infectionb. infection

c. closed head injuryc. closed head injury

d. open head injuryd. open head injury

6. What are Piaget’s four stages of 6. What are Piaget’s four stages of cognitive development? Briefly cognitive development? Briefly characterize each stage. characterize each stage.

7. What evidence is there that motor 7. What evidence is there that motor maps can be modified by experience? maps can be modified by experience?

8. What is the difference between an 8. What is the difference between an angioma and an aneurysm? angioma and an aneurysm?