Cognitive Function

Domains:
Memory
Language
Perception
Executive Function
Praxis

Cognitive dysfunction:
Amnesia
Aphasia
Agnosia
Apraxia
Dysarthia (bulbar muscle defect)


MMSE: Disadvantages
• Language oriented: aphasia
• Perfunctory in tests of memory,
visuoperceptual function
• Executive function eschewed
• Age- and educational bias



Time (5)
Place (5)
Registration (3)
Serial 7s (5)
Recall (3)
Language (2) Name a pencil and watch
Repetition (1)
Complex commands (6)

27-30 Normal
19-24 Mild
10-18 Moderate
Less than 9 Severe












Going off legs
Gait apraxia (loss of ability to execute previously learned skills)
Lesion: pre frontal/frontal lobe – cerebral white matter
Cause: cerebovascular disease, dementia, Normal pressure hydrocephalus
Gait ataxia: Drunk Gait.
- Intention tremor, dysmetria, nystagmus, dysdidochokenisis, Dysarthia, Depression
Causes: Alcohol, B12 deficiency, Thiamine deficiency, Cerebelitis, dementia, M.S, Vascular
Abulia: Lack of will (bilateral lesion to prefrontal cortex)
Extra pyramidal disorders:
Bradykinesia
Tremor
Rigidity
Loss of postural reflexes
Masked facies
Inhibitory (GABA, Dopamine,
Excitory (Glutamate, Dopamine,
Putamen, Substantia Nigra, Globus Pallidus internus, and externus, Subthalamic nucleus.








Peripheral nerves:
Sciatic:
Carpal tunnel syndrome
 Causes include entrapment, excessive use of wrist,tenosynovitis, local infiltration - eg acromegaly, amyloidosis.
 Patients complain of nocturnal paraesthesia affecting the thumb, index and middle fingers.
 Reduced sensation in the same area.
 Severe cases - weakness and wasting of the abductor pollicis brevis.

Sign up to vote on this title
UsefulNot useful