Movement Disorders
John W. Scadding, Nicholas A. Losseff in Clinical Neurology, 2011
Mental disturbances are common. Although the intellect and senses are usually fairly well preserved in the initial stages, most patients develop some degree of intellectual deterioration as the disease progresses. A certain slowness of thought and of memory retrieval (bradyphrenia), is common. The cumulative incidence of dementia is ultimately about 80 per cent. In such cases, the brain always contains increasing numbers of Lewy bodies in the cortex, and often additionally plaques, or sometimes plaques and tangles. When dementia supervenes after more than one year of PD, it is known as PD dementia (PDD). When the interval is less than a year, or when dementia precedes, or occurs without spontaneous, parkinsonism, it is called dementia with Lewy bodies (DLB). Clinically, patients with PDD and DLB can look very similar, particularly in respect to the frequent presence of hallucinations (usually visual) and fluctuating attention, alertness and cognition. The extent to which they are separate conditions or simply represent a continuum is not known. Acute toxic confusional states are often precipitated by inter-current infections or by drug therapy, particularly in those subjects who already show evidence of cognitive decline.
EMI – neurology
Bhaskar Punukollu, Michael Phelan, Anish Unadkat in MRCPsych Part 1 In a Box, 2019
For each of the conditions described below, choose the most likely diagnosis from the list of options. Each option may be used once, more than once or not at all. The patient displayed bradyphrenia, irritability and was socially withdrawn; physically he suffered from axial rigidity, and falls occurred early on during the course of the disease.The 39-year-old patient was referred for psychotic symptoms, during the examination constant irregular movements of his fingers and toes were noted. He could not hold his tongue steady when asked to stick it out.The 54-year-old patient was somnolent, when woken up she was not orientated to time, place or person and when asked to hold her arms and hands outstretched her hands and fingers would often briefly sink down and come up again.
Degenerative Diseases of the Nervous System
Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw in Hankey's Clinical Neurology, 2020
Dementia, usually of the subcortical type and includes: Memory impairment – primarily retrieval, rather than encoding deficits (patients do better than AD patients on recognition memory tasks).Bradyphrenia – slowness of thought processing.Decreased attention.Executive dysfunction.
Mycobacterium avium complex and Cryptococcus neoformans co-infection in a patient with acquired immunodeficiency syndrome: a case report
Published in Acta Clinica Belgica, 2022
Emilien Gregoire, Benoit François Pirotte, Filip Moerman, Antoine Altdorfer, Laura Gaspard, Eric Firre, Martial Moonen, Gilles Darcis
A 28-year-old Belgian Caucasian patient presented at the emergency department complaining about anorexia, dysphagia, weight loss (more than 10% in 6 months), low-grade fever and headache for several weeks. His medical history consisted of uncomplicated gastro-jejunal by-pass surgery at the age of 18. The patient reported unprotected sex, including insertive and receptive anal intercourse with several male partners during the last few years. HIV test was never performed in the past. There was no history of tobacco use nor recreational drug use. Alcohol consumption was occasional. Vital signs at admission showed tachycardia at 130 beats per minute and central temperature of 37.8°C. Arterial blood pressure and oxygen saturation breathing room air were within normal range. At clinical examination, the patient was conscious and well oriented in time and space, but he showed bradyphrenia and irritability. He was cachectic and had pale teguments and dry skin. Oral thrush on posterior tongue and soft palate was a sign of oral candidiasis. Swollen motile sub centimetric lymph nodes were palpable in the neck, axillary pits and groin area. Ophthalmic examination demonstrated deficit in abduction of left eye, sign of palsy of the sixth facial nerve. The rest of the physical examination was normal.
Cognition, function and awareness of disease impact in early Parkinson’s and Huntington’s disease
Published in Disability and Rehabilitation, 2022
Filipa Júlio, Maria J. Ribeiro, Ana Morgadinho, Mário Sousa, Marieke van Asselen, Mário R. Simões, Miguel Castelo-Branco, Cristina Januário
Amidst the several cognitive alterations associated with PD and HD, many of them already present at prodromal disease stages [30,31], bradyphrenia and executive functioning deficits stand out as important and early symptoms of these conditions [29]. Bradyphrenia refers to disproportionately slowed cognition/information processing and is one of the central features of frontal subcortical neuropathology [24,32,33]. Executive functions (EF) are higher-order capacities that enable the successful engagement in independent, purposive, self-serving behaviour and flexible adaptation to daily-life situations [34,35]. The dysexecutive profile of PD and HD includes problems with organizing, planning, sequencing, monitoring and completing tasks, cognitive flexibility, attentional control, set-shifting, inhibitory control, dual task performance and multitasking, judgement and decision-making [1,4,34,36–39]. Impairments in EF have been consistently identified in early manifest HD patients [40–43]. In contrast, the findings of executive dysfunction in PD have been somewhat uneven and the rate of cognitive impairment in early stage PD has been a source of controversy, as deficits can be quite subtle and are usually less severe than those found in HD [4,32]. Particularly, early-onset PD patients (EPD), which have a PD diagnosis before 45 years, often progress more slowly, present a more preserved cognitive function than late-onset PD patients, and rarely develop dementia [24,44,45]. The identification of different cognitive subtypes in PD is thought to be important, as homogeneous groups have a stronger clinical, pathological, and genetic coherence that will facilitate tailored interventional strategies [46].
Manganese concentration in patients with encephalopathy following ephedrone use: a narrative review and analysis of case reports
Published in Clinical Toxicology, 2022
Michal Ordak, Natalia Sloniewicz, Tadeusz Nasierowski, Elzbieta Muszynska, Magdalena Bujalska-Zadrozny
Another case report described by the authors concerned a 23-year-old man who used intravenous ephedrone daily for six months in 2000. He was diagnosed with psychomotor depression. The patient was taciturn, had trouble concentrating and had bradyphrenia. He had problems with his libido and excessive sebum secretion. Neurological examinations revealed hypomimia, spastic-hypokinetic dysarthria, dysphagia, dystonic smile, hypokinesia, stiffness, marked gait disturbance, steppage gait and balance disturbances. The patient was unable to walk independently without falling.
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