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M.P.T (Neuro)
SBSPGI
30% of cerebrum
Area 4, 6, 8 & 44-motor activity
Area 4-primary motor cortex- directly
connected
with somatosensory neurons of
the anterior part
of post central gyrus &
also parietal, thalamic
and red nuclei
and reticular formation of the brainstem.
Area 8 turning the head and eyes to
contralaterally.
Area 44 dominant hemisphere (brocas
area) lips
tongue pharynx larynx bilat
lesion cause
paralysis of phonation,
articulation and
deglutition.
Cat
Monkey
Dog
Human
C/F
motor abnor
Speech and language disorders
Impairment of cognitive function
Akinesia & lack of initiative and spontaneity (apathy
& abulia)
changes in personality, change in mood and self
control
incontinence of bladder and bowel
Motor Abnormalities
posterior part - spastic paralysis of the contralateral
face, arm and leg.
anterior and medial parts of the motor cortex -(area 6
& supplementary motor area of 8 the premotor
cortex) results in less paralysis and more spasticity as
well as a release of sucking, & grasping reflexes
Brocas area - loss of motor speech, agraphia, and
apraxia of the face, lips and tongue
Lesions of motor parts - quadriplegia/paresis-will be
severe and affecting the cranial nerves as well as
spine
Perseveration of speech
dysarthria
Visual Disorders
lesion of white matter of the central and posterior
part of temporal characteristically involve the lower arching
fibres of the geniculocalcarine pathway this results in
upper homonomous quadrantanopia
the middle (area 21) and inferior (area 37) temporal
gyri receive a massive fibres from the striate cortex (area
17) and parastriate visual (area 18 and 19) cortex
bilateral lesions results in psycically blind (can see
and pick up the objects but cant able to recognise)
Visual hallucinations appear too large (macropsia)
and too small (micropsia)
Cortical Deafness
Localization of primary auditory cortex (area 41 and 42) in
the transverse gyri lesions in this area results in
deafness/ effect on hearing
Auditory agnosia
lesions in the secondary cortex area 22 and part
of 21 results in perception of combinations of sound is
impaired.
auditory agnosia takes several forms - inability to
recognize sounds and differrent musical notes (amusia)
appreciation of music is impaired by nondominant
temporal lobe
Auditory Hallucinations
- murmurs, blowing, sound of running water,
whistles, sirens
Vestibular Disturbance
- Superior and posterior part of temporal
(posterior to the primary auditory cortex)
- inducing vertigo
- sense of disequilibrium
Time Perception
- seem to stand still or to pass with great speed
- repeatedly look at the clock
Visual Disorders
Deep to the inferior part of parietal
- involving geniculocalcarine radiations
- results in homonomous hemianopia
Posterior parietal lesion
- defect in localization of visual stimuli
- inability to compare the sizes of objects
- failure to avoid objects when walking
- inability to count objects
- striking disorder of motor behavior of eyelids
Verger-Dejerine Syndrome
- loss of position sense
- astereognosis
- impairment in two point descrimination
- impairment to recognize figures written on the
skin
Parietal sensory deficit
- inconsistency of response to painful stimuli
- difficulty in distinguishing more than one contact
at a time
- occurrence of hallucination of touch
Asomatognosias
- perception of ones own body and of the relation
of bodily parts to one another
- depends upon the visual and labyrinythine
impulses
Unilateral asomatognosia (Anton Babinski Syndrome)
- anosognosia (asked to raise the paralyzed arm,
patient will raise the intact arm)
- pt may fail to shave one side
- fail to apply lipstick or comb the hair on one side
- impossible to wear eyeglasses
- dressing on one side
Bilateral Asomatognosia
"Gerstmann's Syndrome
Right-left confusion
Agraphia
Acalculia / Dyscalculia
Aphasia
Agnosia
Ideomotor and ideational apraxia
- colors
- stars
- multiple lights
- geometric forms
lesion indication of visual associative area
Visual agnosia
- Object agnosia
- simultagnosia
- Balint syndrome (hand eye incoordination)
- Prospognosia (face ID)
- Visual disorientation
- color agnosia
References