INTRODUCTION TO NEUROLOGICAL CONDITIONS 9

ANOMIA

loss of power of naming objects or recognizing names

ECHOLALIA

a condition in which the patient repeats, parrot-like words, or phrases that he/she hears

AGRAMMATISM

a condition in which the language content of spontaneously uttered sentences is condensed, missing many of the filler words

AGRAMMATISM

pathological inability to use words in grammatical sequence.

• operculum

• insula

AGRAMMATISM lesion:

PARAGRAMMATISM

misuse of grammatical elements usually during fluent utterances

PARAGRAMMATISM

inability to form grammatically correct sentences

CIRCUMLOCUTION

description of an object by its use or function or by definition because of inability to recall its name.

STUTTERING

machine gun like the repetition of the first syllable of a word

STUTTERING

defined as gaps, prolongations, or involuntary repetitions of a sound or syllable that occur during speech production

STAMMER

prolong silence following a syllable

DELUSION

the false belief that is quite inappropriate to an individual’s socio-cultural background.

HALLUCINATION

a perception occurring in the absence of any external stimuli; maybe auditory, visual, olfactory, gustatory, etc.

ILLUSIONS

a perceptual misinterpretation of a “real” sensory stimulus that is, an interpretation that contradicts objective “reality”

DELIRIUM

a type of confusional state characterized by gross disorientation in the presence of heightened alertness

DELIRIUM

a disorder of perception in which illusions and vivid Hallucinations are prominent and overactivity of psychomotor and autonomic nervous function

DEMENTIA

literally means the undoing of the mind

DEMENTIA

a deterioration of all intellectual and cognitive functions without disturbance of consciousness or perception.

DELIRIUM

Common Causes: Severe infections, alcohol withdrawal, drug intoxication

DEMENTIA

Common Causes: Cerebral atrophy (Alzheimer’s disease); alcoholism, drug intoxication

PURE WORD DEAFNESS

impaired auditory comprehension and inability to repeat what is said or to write a dictation

PURE WORD BLINDNESS

a rare disorder in which a literate person loses the ability to read and often name colors (visual-verbal color anomia)

PURE WORD MUTISM

losses all the capacity to speak while retaining the ability to write, to understand spoken words, and to read silently with comprehension

ANOMIC APHASIA

the patient losses only the ability to name objects, there are typical pauses in speech, groping for words, circumlocution and substitution.

250 and 8000 hertz

Frequencies heard can be tested in what Hz?

decibels (dB)

Intensity is measured

Intensity

is measured in decibels (dB) of sound pressure levels and can be tested from 0 t0 120 dB

0 - 120 dB

Intensity is measured in decibels (dB) of sound pressure levels and can be tested from?

125 Db

the threshold of pain?

400 - 4000 Hz

“Speech range”

• Conductive Hearing Loss

• Deafness

Causes: Foreign bodies; occluding cerumen; perforated eardrum; malformation of the outer ear, ear canal, or middle ear structure; Fluid in the middle ear from colds; tumors; infection (otitis media); otosclerosis

• External ear

• middle ear

Conductive Hearing Loss/Deafness Site of Lesion:

• Conductive Hearing Loss

• Deafness

Response to audiometry: Bone conduction is normal, but air conduction is greatly decreased in all frequencies

• Sensorineural Hearing Loss

• Nerve deafness

Causes: Antibiotic toxicity; prolong exposure to noise/noise-induced or trauma; CN 8 tumor; vascular damage to the medulla; viral/bacterial illness; Meniere’s disease; presbycusis; hereditary

CN 8

• Sensorineural Hearing Loss

• Nerve deafness

CRANIAL NERVE TUMOR?

Meniere’s disease

• Sensorineural Hearing Loss

• Nerve deafness

WHAT DISEASE?

• Sensorineural Hearing Loss

• Nerve deafness

Response to audiometry: Deafness is mainly for high freq. sound

Mixed Hearing loss

a combination of the Conductive and sensorineural hearing loss

Reconstructive microsurgery

Conductive Hearing Loss/Deafness Treatment:

Supportive/hearing aids

Sensorineural Hearing Loss/Nerve deafness Treatment:

Upper motor neuron (UMN) syndrome

As a result of damage to the CNS and descending pyramidal tracts.

Upper motor neuron (UMN) syndrome

Muscle affected are in groups

Upper motor neuron (UMN) syndrome

Atrophy is slight due to disuse

Lower motor neuron (LMN) syndrome

lesions that affect the anterior horn cell and peripheral nerve

Lower motor neuron (LMN) syndrome

An individual muscle may be affected, groups

Lower motor neuron (LMN) syndrome

(neurogenic) atrophy is pronounced (up to70 – 80%)

Lower motor neuron (LMN) syndrome

Flaccidity and hypotonia present with loss of DTR’s

Upper motor neuron (UMN) syndrome

Spasticity is present with hyperactivity of the tendon reflex and extensor response (Babinski sign)

Upper motor neuron (UMN) syndrome

Absent fascicular twitches

Lower motor neuron (LMN) syndrome

fascicular twitches and fibrillations may be present

Lower motor neuron (LMN) syndrome

Abnormal NCV in EMG

Upper motor neuron (UMN) syndrome

Normal NCV, no denervation potential

MUSCLE TONE

Defined as the resistance of muscle to passive elongation or stretch

MUSCLE TONE

represents a state of slight residual contraction in normally innervated, resting muscle, or steady-state contraction.

• hypertonia

• hypotonia

• dystonia

MUSCLE TONE ABNORMALITIES

Hypertonia

increased tone above normal resting levels → Can either be spasticity or rigidity

SPASTICITY

a motor disorder characterized by a velocity-dependent increase in muscle tone with increased resistance to stretch.

SPASTICITY

has to increase in tonic stretch reflex with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex

RIGIDITY

increased resistance to passive motion which affects all striated muscles.

Clonus

is characterized by the cyclical, spasmodic alternation of muscular contraction and relaxation in response to sustained stretch of a spastic muscle