8/9/2019 Disorders of Higher Nervous Functions

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Some Disorders of Higher Nervous Functions

Disorders Manifestations Localization of lesion

Motor

Aphasia

Disturbance of expressive (spoken) language

while maintaining the understanding of spoken

and written speech

Posterior part of inferior frontal

gyrus (Broca's area) of dominant

hemisphere

Touch

Aphasia

Disturbance of impressive speech (understanding

speech), a secondary disturbance of expressive

speech due to lack of auditory control

Middle and posterior part of

superior temporal gyrus (Wernicke's

area) of dominant hemisphere

Total Aphasia

Loss of ability to speak and understand speech Frontal, parietal and temporal lobes

of the dominant hemisphere (lesion

in areas of Broca and Wernicke)

Amnesic

Aphasia

Difficulties in selection of words and naming

objects, little difficulty in understanding speech

and pronunciation of words

Angular gyrus, posterior part

temporal lobe of the dominant

hemisphere

Astereognosis

Loss of the ability to identify objects by touch ing

with eyes closed

Superior part of parietal lobe of the

dominant hemisphere

AnosognosiaIgnoring existing neurological defect or

underestimation of its severity

Extensive damage subdominant

hemisphere

Visual Agnosia

Loss of ability to recognize certain objects (letters,

faces, perception of space)

Occipital lobe with a possible partial

lesion of posterior part of parietal

and temporal lobes

Apraxia

Loss of complex targeted actions (personal and

professional skills) with preservation of

elementary motor acts

Frontal and parietal lobe of the

dominant hemisphere

Amnesia

(modal-non-specific)

Disturbance of storing information of different

modalities

Defect of the structures of the

hippocampal circle

Summary of Degenerative Diseases Causing Development of Dementia

Summary Alzheimer Disease Dementia withLewy bodies Fronto-temporal Dementia

Clinical

picture

Dementia with progressive

amnesia and connection of

aphasia, agnosia, apraxia

and disorders of other

higher nervous functions

Progressive dementia, as in

Alzheimer's disease, periods of

confusion, hallucinations and

paranoid mania, symptoms of

Parkinsonism

Progressive dementia,

combined with apathy,

decline in mental and motor

activity, perhaps progressive

disorder of speech

CT or MRI of

the head

Atrophy of the temporal and

parietal lobesDiffuse cerebral atrophy

Pronounced atrophy of the

frontal and temporal lobes

DiagnosisBased on the clinical picture, absence of other causes of dementia according to clinical, CT

and MRI of the head