TBI
What is the defining criteria of a TBI?
An alteration in brain function or other evidence of brain pathology caused by an external force and characterized by: 1) any period of loss of consciousness, 2) any memory loss for the events immediately before or after the injury, 3) any neurological deficits, 4) any alteration in mental state at the time of the injury
Are primary brain tumors more common in adults or children?
Children
What is kindling? automatism? aura?
Kindling - the development of an epileptogenic network by exposure to recurrent seizures
Automatism - a more or less coordinated, repetitive motor activity usually occurring when cognition is impaired and for which the subject is usually amnestic afterwards. This often resembles a voluntary movement and may consist of inappropriate continuation of ongoing preictal activity
Aura - subjective sensory phenomena that precedes a seizure and may serve as a warning that a seizure may be imminent
How do clonic seizures present? Tonic? Myoclonic?
Clonic: brief rhythmic jerking movements of muscles affecting both lower and upper extremities
Tonic: sudden onset of bilateral tonic extension or flexion of the head, trunk, or extremities
Myoclonic: quick jerks, involving symmetric movements of the head, distal limbs, or axial musculature
Do late life or early life psychiatric symptoms increase the risk of developing dementia?
Late life
Loss of consciousness for 30 minutes or less would be what severity of TBI?
Mild
Medulloblastoma’s are:
Fast growing, high grade tumors
______ behaviors are behaviors that occur during a seizure, _______ is the period between seizures, and ______ is the period of time after a seizure, during which time patients often experience confusion or drowsiness
Ictal; interictal; postictal
What lifestyle changes are recommended for patients with epilepsy?
1) Adequate sleep, 2) avoiding alcohol & stimulants, 3) avoid triggers, 4) reduce stress, 5) ketogenic diet
Describe the main symptoms of apathy
Emotional blunting, lack of social engagement, increased indifference
A moderate TBI is loss of consciousness for ____ to ____. A severe TBI is loss of consciousness for more than _____
30 minutes; 24 hours
24 hours
The most common primary brain tumors in adults are _______ and _______. _______ are the most common symptom of brain tumors.
meningiomas; gliomas; Headaches
What is the typical etiology of seizures and epilepsy in older adults? What is the most identifiable cause?
1) Stroke, 2) brain tumor, 3) acute metabolic disturbances, 4) neurodegeneration
Most identifiable cause: stroke
Common seizure type of focal seizures and focal to bilateral seizures are usually found in patients with what condition?
Brain tumors
What are the psychosocial risk factors of a stroke?
1) pre-stroke history of depression, 2) personality and coping style, 3) inadequate social support, 4) level of disability
What are the symptoms of Post Concussive Syndrome?
1) headache, 2) blurred vision, 3) dizziness/imbalance, 4) concentration difficulties, 5) forgetfulness, 6) slowed thinking, 7) sleep disturbance, 8) irritability
Chemotherapy can cause what neuropsychological deficits?
Deficits in 1) executive functioning, 2) processing speed, 3) learning and memory
Anti-epileptic drugs can lead to cognitive concerns in _______, _______, and slowed _______
memory; attention; processing speed
Parietal lobe epilepsy can cause what symptoms?
1) Sensory disturbance, 2) visual disturbance, 3) motor disturbance, 4) mood disturbance
What are the rare behavioral symptoms of dementia?
Euphoria, sleep abnormalities, & appetite disturbances
What are the common neuropsychological deficits associated with TBIs?
1) Deficits in processing information, 2) deficits in executive functioning, 3) poor attention
___________ cause increased cranial circumference in children, irritability, sleeplessness, vomiting as the tumor grows, and headaches
___________ cause headaches, nausea, vomiting, and drowsiness. Depending on the location of the tumor, patients can develop a variety of other symptoms such as hemiparesis, memory, speech difficulties, and vision changes
Ependymomas; Glioblastomas
Temporal lobe epilepsy can cause what symptoms?
Aura that involves wide eyed stare followed by oral automatisms (lip smacking, swallowing, or chewing movements) and/or automatisms of the upper extremities (pill rolling movement or picking with hands) and altered consciousness.
Neuropsychological impairment is common, but lateralization is noted depending on location of the seizure. Deficits in general cognitive ability, academic achievement, language, memory, attention, executive functioning, motor skills, and visuospatial functioning
Frontal lobe epilepsy can produce what neuropsychological deficits?
1) behavioral changes, 2) deficits in motor skills, 3) inattention, 4) decreased working memory, 5) executive dysfunction, 6) lower fluency scores
Lesions in the left hemisphere result in:
1) recognizing positive emotions more easily, 2) less spontaneous talking, 3) more aware and concerned about deficits, 4) more likely to have post-stroke depression