Neurocognitive Disorders

Flashcards about Neurocognitive Disorders advancements, symptoms, diagnosis and treatments

Cognition

Include memory, language, orientation, judgment, conducting interpersonal relationships, performing actions (praxis), and problem-solving.

Cognitive disorders

Reflect disruption in one or more domains of cognition, often complicated by behavioral symptoms.

Delirium

A condition of short-term confusion and changes in cognition, with subcategories based on various causes such as medical conditions, substances, or multiple etiologies.

Dementia (Major Neurocognitive Disorder)

Marked by severe impairment in memory, judgment, orientation, and cognition.

Mild neurocognitive disorder

Describes a less severe form of dementia.

Amnestic Disorder

Major neurocognitive disorders caused by other medical conditions and marked primarily by memory impairment in addition to other cognitive symptoms.

Electroencephalography (EEG)

An easily accessible, noninvasive test of brain dysfunction with high sensitivity for many disorders but relatively low specificity; useful in detecting altered electrical rhythms associated with mild delirium, space-occupying lesions, and continuing complex partial seizures.

Computed tomography (CT) and magnetic resonance imaging (MRI)

Have proved to be powerful neuropsychiatric research tools; MRI has mostly replaced CT; CT is still the test of choice for patients with acute cerebral hemorrhages or hematomas.

Neuropsychologic Testing

Provided a standardized, quantitative, reproducible evaluation of a patient’s cognitive abilities which may be useful for initial evaluation and periodic assessment.

Delirium

An acute decline in both the level of consciousness and cognition with particular impairment in attention.

consciousness

The hallmark symptom of delirium is an impairment of _.

Core Features of Delirium

Include altered consciousness (usually decreased level), altered attention, disorientation, impaired memory, relatively rapid onset, brief duration, marked, unpredictable fluctuations in severity, and sometimes worse at night (sundowning).

How Delirium is usually diagnosed

A sudden onset of symptoms.

Mini-Mental State Examination

A bedside mental status examination —can be used to document the cognitive impairment and to provide a baseline from which to measure the patient’s clinical course.

Dementia (Major Neurocognitive Disorder)

Is a disease process marked by progressive cognitive impairment in clear consciousness.

DSM-5 Symptoms of Dementia

There a significant or moderate decline in cognitive functioning in areas such as attention, executive function, learning/memory, language, perceptual-motor, and social cognition.

Complaints of a personality change in a patient older than age 40 years

Suggest that we should consider a diagnosis of dementia.

Memory impairment

Typically an early and prominent feature in dementia, especially in dementias involving the cortex, such as dementia of the Alzheimer type.

Lability of emotions, sloppy grooming, uninhibited remarks, silly jokes, or a dull, apathetic, or vacuous facial expression and manner

Suggest a diagnosis of dementia, especially when coupled with memory impairment.

Dementia of the Alzheimer type and vascular dementia

Are the most common type of dementia.

Changes in the personality of a person with dementia

During the development of dementia, preexisting personality traits may accentuate.

Personality Disorders

The most frequent psychiatric abnormalities reported in patients with epilepsy, and they are especially likely to occur in patients with epilepsy of temporal lobe origin.

Mood

In patients with dementia, depression and anxiety are significant symptoms.

Sundowner Syndrome

Is characterized by drowsiness, confusion, ataxia, and accidental falls.

Vascular dementia

Has been distinguished from dementia of the Alzheimer type by the decremental deterioration that can accompany cerebrovascular disease over time.

Symptoms of Delirium

Rapid onset, brief duration, cognitive impairment fluctuation during the day, nocturnal exacerbation of symptoms; marked disturbance of the sleep–wake cycle; and prominent disturbances, attention, and perception.

Amnestic disorder

A circumscribed loss of memory and no deterioration that requires we should rule out a pituitary disorder, but the disorders are a rare cause.

Course and Prognosis of Dementia

Classic course of dementia is onset in the patient’s 60s, with gradual deterioration over 5 to 10 years, leading eventually to death.

Symptoms of Dementia

Multiple cognitive domains are affected and cognitive deficits cause significant impairment in social and occupational functioning.

Dementia

A disease process marked by progressive cognitive impairment in clear consciousness and is potentially partially reversible.

Amyloid precursor protein (APP)

The gene for _ is on the long arm of chromosome 21.

Mr. J from the case study

A 70-year-old retired businessman.

Binswanger Disease

Is characterized by the presence of many small infarctions of the white matter that spare the cortical regions.

Psychosocial Treatments

Affect the development, severity, and even slightly treat dementia diseases.

Studies on Gentic Factors

Suggest that as many as 40% of patients have a family history.

Pick disease

Preponderance of atrophy in the frontotemporal regions.

Dementing processes that affect the cortex, primarily Alzheimer-type dementia

Can affect patients’ language abilities.

Lewy Body Disease

Clinical, same as Alzheimer, but patients present with hallucinations, parkinson features, and extrapyramidal signs.

HIV-associated neurocognitive disorder

Involves impaired cognitive functioning and reduced mental activity that interferes with work, domestic, and social functioning.

Amyotrophic Lateral Sclerosis

Is a progressive, noninherited disease of asymmetrical muscle atrophy that begins in adult life.

Lyme Disease

Is caused by infection with the spirochete Borrelia burgdorferi transmitted through the bite of the deer tick.

Prion Disease

Is a group of related disorders caused by a transmissible infectious protein known as a prion.

Anti-NMDA (N-methyl D-aspartate)-receptor encephalitis

Causes dissociative symptoms, amnesia, and vivid hallucinations.

Wernicke-Korsakoff Syndrome

Can be caused by vitamin B1 (thiamine) deficiency and is characterized by confusion, ataxia, and ophthalmoplegia (eye muscle paralysis).

Progressive Supranuclear Palsy

Is a rare neurodegenerative disorder characterized by the accumulation of abnormal tau protein in the brain, leading to progressive dementia and motor dysfunction.