Cerebral Neurology: Dementia, Death and Coma MCQs

Kluver-Bucy Syndrome Occurs due to Bilateral Ablation of the Amygdala Characterized by, Not able to recognize objects by sight - Visual agnosia Tendency to examine objects excessively by mouth Hyperorality Compulsion to intensively explore the immediate environment - Hypermetamorphosis No longer show fear or anger, even when such a reaction is appropriate - Placidity Eat excessively even when not hungry, or may eat objects that are not food - Hyperphagia Augmentation in sexual behavior - Hypersexuality Reference: Guyton, 13th edition page no.760

This patient has normal pressure hydrocephalus (PH), which is a clinical syndrome produced by the build-up of cerebrospinal fluid (CSF). Patients have enlarged ventricles often with normal opening pressures on lumbar puncture. It is characterized by the classic triad (with the accompanying mnemonic): "Wet": urinary incontinence "Wacky": dementia (memory loss, slowed thought) "Wobbly" gait abnormality (apraxic "magnetic" gait) PH is thought to be caused by impaired CSF absorption by arachnoid granulations. It is idiopathic in half of the cases. Secondary causes include meningitis, brain trauma, subarachnoid hemorrhage, or prior brain surgery. The treatment for NPH is ventricular shunting. A ventriculoperitoneal shunt drains excess CSF to the abdomen, where it is absorbed. Reference: Basic & Clinical Pharmacology, Fourteenth Edition By Bertram G. Katzung Pg no. 503-504

Answer- C. Parietal Medial temporal lobe is the area of brain responsible for consolidation, i.e. processing of short term memory into long term memory. 1043. Gerstmanns syndrome all except a) Acalculia b) Agraphia c) Aphasia d) Agnosia Correct Answer - C Answer- C. Aphasia Gerstmann syndrome consists of :

Short term memory impairment is the commonest clinical presentation of Alzheimer's disease. Usually patients are fully orientated in time, person and place. Long term memory is usually intact. The best way to test short term memory is to ask the patient to recall new information in the next few minutes. Reference: Harrison's Principles of Internal Medicine, 21 st ed, Ch: 29, Pg: 192

Damage to the hippocampus and parahippocampus results in memory problems and has early involvement in Alzheimer's disease. Entorhinal cortex is also involved The corpus callosum can be involved in multiple sclerosis where so-called Dawson's fingers can be seen. Posterior parietal lobe is involved in DLB Cortical ribboning and basal ganglia and thalamus hyperintensity is seen in CJD Reference: Harrison's Principles of Internal Medicine, 21 st ed, Ch: 29, Pg: 192

This patient has parkinsonism, with bradykinesia and rigidity. In view of the deterioration in mental function and delusion, Lewy body dementia is more likely than Parkinson's disease. In Parkinson's disease dementia occurs in long standing disease. Reference: Harrison's Principles of Internal Medicine, 21 st Ed, Ch: 434 Pg: 3385

This patient is definitely suffering from a dementing disease. The chief domains affected are language, social skills and hyperorality. These are the characteristic features of Frontotemporal dementia. Other features that may be seen include, symptoms of MND and dystonia. PD presents with memory loss only later after the progression of motor symptoms. In DLB, the chief domain affected are visuospatial skills and psychiatric manifestations like visual hallucination. Reference: Harrison's Principles of Internal Medicine, 21 st ed, Ch: 432, Pg: 3378

Ans. is 'c' i.e., More dangerous than decerebrate lesion Decortical Posture o Also known as flexor posturing or Mummy baby o Arms flexed/bent over chest, hand fisted, leg extended & rotated inward o Damage to area in cerebral hemisphere, internal capsule, thalamus & upper part of brain. o Decorticate posture is ominous sign of severe brain damage. Decerebrate posture o Also known as extensor posturing o Extension of upper limb & lower limb (ELBOW EXTENDED) o Indicates brain stem damage (Below level of red nucleus) o Decerebrate posture is more ominous than decortical posture