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Neurological Disorders

• Human Neuropsychology (486 / 686)
• Lecture Chapter 26

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The Neurological Examination

• Patient History
• Patient and family background and disease history
• Observation of behavior and state of awareness
• Simple tests of memory and speech
• The Physical Examination
• Head and body size, Blood pressure
• Various reflexes
• Smell and taste, sensation and hearing
• Sensitivity to light
• Muscular strength
• Object recognition, speech repetition

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Vascular Disorders

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

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Vascular Disorders

• Ischemia lack of blood supply
• Causes Thrombosis, Embolism, Cerebral
  Arteriosclerosis, Cerebral Vascular Insufficiency
  (transient ischemia)
• Migraine stroke - Appears as a transient ischemic
  attack
• Symptoms Impaired sensory function, Numbness,
  Difficulty moving, Aphasia
• Cerebral Hemorrhage bleeding
• most common cause high blood pressure

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Vascular Disorders

• Angiomas - Collection of abnormal blood vessels

• Angiomas -
• Arteriovenous Malformation

• Aneurysms - Vascular dilation

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Treatments

• Drug therapies
• Anticoagulants, blood pressure meds,steroids

• Surgeries

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Traumatic Brain Injuries

• Open Head Injury penetrating wounds,
• deficits specific to injury site, greatest risk
  of infection
• Closed Head Injury
• forces that cause damage coup, countercoup,
  twisting and shearing, bleeding and edema

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Closed-Head Injuries

• Coma
• Behavioral effects
• General complaints
• Risk for future head injury
• Cumulative effects

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Behavioral Assessment

• Glasgow Coma Scale

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Behavioral Assessment

• Post-Traumatic Amnesia (PTA)

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Epilepsy

• Three common symptoms
• Diagnosed with EEG

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Types of Seizures

• Focal
• Jacksonian, Complex partial
• Generalized
• Grand Mal, Petit Mal
• Akinetic and Myoclonic
• Anticonvulsant drugs
• Surgery

Treatment for Epilepsy
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Tumors

• Benign vs Malignant
• Encapsulated vs Infiltrating
• Types
• Gliomas, Meningiomas, Metastatic
• Treatment
• Surgery, Radiation, Chemotherapy

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Gliomas
oligodendroglioma
astrocytoma
ependymoma
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Menigiomas
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Metastatic tumors
From Lung cancer
From skin cancer
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Headaches Migraine

• Classic migraine
• Common migraine
• Cluster headache
• Hemiplegic and ophthalmologic migraine
• Treatment Specific drugs to prevent and control
  pain e.g. topamax, ergotamine

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Other Headaches

• Neurological disease related
• Causes tumor, head trauma,infections, vascular
  malformation, hypertension
• treatment treat the cause
• Muscle-contraction headaches (tension)
• treatment Analgesics, Muscle relaxants,
  tranquilizers, posture improvement, reduce stress
• Nonmigrainous vascular headaches
• Causes Fever, anoxia, anemia, high altitude,
  physical effort, hypoglycemia, food, or chemical
  agents

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Infections

• Interfere with blood supply, Disrupt glucose or
  oxygen metabolism, Alter cell membranes, Form
  pus, Edema
• Types
• Viruses neurotropic, pantropic
• treatment Difficult to treat no antidote
• Bacteria Meningitis, Brain abscesses
• treatment Antibiotics, Drainage
• Mycotic Infections fungus
• Parasitic Infections Amebiasis,Malaria
• No satisfactory treatment, Antibiotics

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Motor Neurons and the Spinal Cord

• Myasthenia Gravis
• Poliomyelitis
• Multiple Sclerosis
• Paraplegia
• Brown-Séquard Syndrome
• Hemiplegia

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• 1. Moran and Desimone showed that monkey neurons
  responded selectively to specific stimuli in
  their visual fields
• a. after reward training
• b. when the stimulus was presented to the right
  visual hemifield
• c. when the stimulus was presented to the left
  visual hemifield
• d. when the stimulus was a particular color

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• 2. Which of the following processes are necessary
  prerequisites of consciousness?
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• a. attention and perception
• b. working memory
• c. arousal
• d. all of these processes are necessary

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• 3. Dendrite growth differs from axonal growth in
  that
• a. axons grow faster than dendrites in order to
  play a role in shaping dendritic growth
• b. axons grow faster than dendrites in order to
  reach a larger maximum size
• c. dendrite grow faster than axons in order to
  play a role in shaping axonal growth
• d. dendrite grow faster than axons in order to
  reach a larger maximum size

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• 4. After a series of higher than normal
  stimulations followed by a rest period, a
  baseline stimulation to a neuron elicits a
  greater excitatory post synaptic potential from
  another neuron that receives its projections.
  This phenomenon is known as
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• a. kindling
• b. long-term potentiation
• c. ischemia
• d. synaptogenesis

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• 5. Countercoup damage is the result of
• a. aneurysm
• b. infection
• c. closed head injury
• d. open head injury

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• 6. What are Piagets four stages of cognitive
  development? Briefly characterize each stage.
• 7. What evidence is there that motor maps can be
  modified by experience?
• 8. What is the difference between an angioma and
  an aneurysm?