This presentation briefs out the approach of dementia assessment in line with consideration of recent advances. Now the pattern of assessment has evolved towards examining each individual domain rather than lobar assessment.
This presentation looks at generalised periodic epileptiform discharges and the various disorders like Creutzfeldt Jacob disease (CJD), SSPE and metabolic encephalopathies in which it is seen. SIRPID is also discussed. Triphasic waves are described. Radermacker complexes in SSPE are described.
This presentation looks at abnormal EEG patterns with examples for each. Benign variants, artifacts and focal ictal patterns are not part of this presentation.
This presentation looks at generalised periodic epileptiform discharges and the various disorders like Creutzfeldt Jacob disease (CJD), SSPE and metabolic encephalopathies in which it is seen. SIRPID is also discussed. Triphasic waves are described. Radermacker complexes in SSPE are described.
This presentation looks at abnormal EEG patterns with examples for each. Benign variants, artifacts and focal ictal patterns are not part of this presentation.
Mental Health and Cognitive Changes in the Older AdultPaul McNamara
As we get older, the likelihood of undergoing alterations to brain function is high. This may include normal neurodegenerative changes as well as abnormal deteriorations. Separating normal from dysfunctional degeneration when screening and assessing an older adult is essential for quality nursing care planning. This session will look at:
What are normal age-related changes to the brain and consequent behavioural signs?
How are these changes different to the onset of mental health disorders such as schizophrenia, psychosis or bipolar disorder?
Age appropriate assessment tools for effective mental health assessment
Benefits of brief psychosocial interventions
What practical behavioural strategies may improve outcomes for a person with a mental health disorder and cognitive changes?
Mental Health and Cognitive Changes in the Older AdultPaul McNamara
As we get older, the likelihood of undergoing alterations to brain function is high. This may include normal neurodegenerative changes as well as abnormal deteriorations. Separating normal from dysfunctional degeneration when screening and assessing an older adult is essential for quality nursing care planning. This session will look at:
What are normal age-related changes to the brain and consequent behavioural signs?
How are these changes different to the onset of mental health disorders such as schizophrenia, psychosis or bipolar disorder?
Age appropriate assessment tools for effective mental health assessment
Benefits of brief psychosocial interventions
What practical behavioural strategies may improve outcomes for a person with a mental health disorder and cognitive changes?
'Understanding Chinese Developmental Dyslexia...' By Professor Alice Lai Dyslexia International
Slide presentation World Dyslexia Forum 2010 'Understanding Chinese Developmental Dyslexia...' By Professor Alice Lai
For all films: http://di-videos.org/player/worlddyslexiaforum/2010/#/lg/EN/
April 27, 2018
With over 70 million Baby Boomers retiring, elder financial exploitation has been labeled the “Crime of the 21st Century.” In this half-day event, we will explore the neuroscience, psychology, and legal doctrine of financial decision-making in older adults. How does the aging brain make financial decisions, and when is it uniquely susceptible? How can courts best use science to improve their adjudication of disputes over “competency”, “capacity”, and “undue influence”? Is novel neuroimaging evidence of dementia ready for courtroom use? This conference brought together experts in medicine, science, and law to explore these important questions and chart a path forward for dementia and the law.
For more information, visit our website at: http://petrieflom.law.harvard.edu/events/details/our-aging-brains
CONCEPT OF NODOPATHIES AND PARANODOPATHIES.pptxNeurologyKota
emergence of autoimmune neuropathies and role of nodal and paranodal regions in their pathophysiology.
Peripheral neuropathies are traditionally categorized into demyelinating or axonal.
dysfunction at nodal/paranodal region key for better understanding of patients with immune mediated neuropathies.
antibodies targeting node and paranode of myelinated nerves have been increasingly detected in patients with immune mediated neuropathies.
have clinical phenotype similar common inflammatory neuropathies like Guillain Barre syndrome and chronic inflammatory demyelinating polyradiculoneuropathy
they respond poorly to conventional first line immunotherapies like IVIG
This presentation contains information about Dementia in Young onset. Also it describes the etiologies, clinical feature of common YOD & their management.
Entrapment Syndromes of Lower Limb.pptxNeurologyKota
This presentation contains information about the various Entrapment syndromes of Lower limb in descending order of topography. It also contains information about etiology, clinical features and management of each of these entrapment syndromes with special emphasis on electrodiagnostic confirmation.
This presentation consist information about Brain death with special emphasis to differences between Indian and Western Guidelines. Also consist information about Organ transplantation and related act.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
Navigating the Health Insurance Market_ Understanding Trends and Options.pdf
Domain Assessment in Dementia.pptx
1. Presenter: Dr. Kshitij Bansal
Senior Resident
Department of Neurology
Government Medical College, Kota
DOMAIN ASSESSMENT IN DEMENTIA
2. SCHEME OF PRESENTATION
Introduction
Scales
Attention
Language
Memory
Visuospatial function
Praxis
Executive Function
3.
4. HMF GUIDELINES
General Principles
Specific cognitive testing: Brief screening Mental Status Examination.
Scales: MMSE and MOCA
Neuropsychological testing
Test each area with more than one task.
Normal or abnormal if > 3 /4 examples.
Confounding variables (Assess sensory deficits).
Hierarchical (attention impacts memory)
6. Scoring below the level of education-adjusted
cut-off on the MMSE may indicate cognitive
impairment. Generally, a score of 24 to 30 is
normal depending on education among total
MMSE score = 30.
Education levels of 7th grade or lower:
MMSE score of 22 or below
Education level till only high school: MMSE
score of 24 or below
Education level of high school graduate:
MMSE score of 25 or below
Education level of college or higher: MMSE
score of 26 or below
CRUM RM, ANTHONY JC, BASSETT SS, FOLSTEIN MF. POPULATION-BASED NORMS FOR THE MINI-
MENTAL STATE EXAMINATION BY EDUCATIONAL LEVEL. JAMA. 1993 MAY 12;269(18):2386-91.
7.
8. KONSTANTOPOULOS K, VOGAZIANOS P, DOSKAS T. NORMATIVE DATA OF THE MONTREAL COGNITIVE ASSESSMENT IN THE GREEK POPULATION AND PARKINSONIAN DEMENTIA. ARCHIVES OF
CLINICAL NEUROPSYCHOLOGY. 2016 MAY 1;31(3):246-53.
12. DIGIT FORWARD AND BACKWARD TEST
Attention:
Digit Span: Direction: Tell the patient, “I am going to read a list of
numbers. Listen carefully and when I am finished, repeat same
numbers after me.” Present the digital in a normal tone of voice at a
rate of one digit per second.
“A” Test: Direction: Tell the patient, “I am going to read you a long
series of letters. Whenever you hear the letter A, indicate by tapping
the desk.” Read the following letter list in a normal tone at a rate of
one letter per second.
(Read only line 1 unless you need a larger sample)
Omissions: _____
Commissions: _____
13. MONACO M, COSTA A, CALTAGIRONE C, CARLESIMO GA. FORWARD AND BACKWARD SPAN FOR VERBAL AND VISUO-SPATIAL DATA: STANDARDIZATION AND NORMATIVE DATA FROM AN ITALIAN
ADULT POPULATION. NEUROLOGICAL SCIENCES. 2013 MAY;34:749-54.
14. ATTENTION
Attention:
DIGIT VIGILANCE TEST, SUSTAINED ATTENTION:
Say “cancel digit 6 and 9 as fast as he can. Do not cancel any other digit and do not miss any target
digit”. Note down the time and errors.
Time:
Errors of omission:
Errors of commission:
15. DIGIT VIGILANCE TEST
Age range: 20 to 80 years
Admin time: 10 minutes (Timed)
Respondents are asked to find and cross out either sixes
and nines, which appear randomly within 59 rows of
single digit on two separate pages.
LIN GH, WU CT, HUANG YJ, LIN P, CHOU CY, LEE SC, HSIEH CL. A RELIABLE AND VALID ASSESSMENT OF SUSTAINED ATTENTION FOR
PATIENTS WITH SCHIZOPHRENIA: THE COMPUTERIZED DIGIT VIGILANCE TEST. ARCHIVES OF CLINICAL NEUROPSYCHOLOGY. 2018
MAR;33(2):227-37.
16. STROOP TEST
MACLEOD CM, MACDONALD PA. INTERDIMENSIONAL INTERFERENCE IN THE STROOP EFFECT: UNCOVERING THE COGNITIVE AND NEURAL ANATOMY OF ATTENTION. TRENDS IN COGNITIVE SCIENCES. 2000
OCT 1;4(10):383-91.
17. TRAIL A AND TRAIL B TEST
WECHSLER, D. MANUAL FOR THE WECHSLER ADULT INTELLIGENCE SCALE, 3RD ED, THE
PSYCHOLOGICAL CORPORATION, SAN ANTONIO 1997.
19. LANGUAGE
Spontaneous Speech
“Tell me about your illness” – Observe articulation, prosody, fluency, grammar and paraphasia and
neologisms.
Normal Fluency: 100-150 words / miutes
Sentence length: > 7 words
Verbal fluency test: Animal or vegetable naming test (60 sec) < 13 impaired.
Phonemic fluency: Say as many words as you can which begins with KA, PA, MA (give 60 seconds for
each sound) – no repletion of words, no names of person or places or derivations of same word.
20. VERBAL FLUENCY TEST
Phonemic (letter): (eg. Letter D or S, or FAS):
Sensitive to frontal lobe lesions
Normal 10-11 / min.
Semantic (Category): (eg. Animals, grocery items)
Sensitive to frontal and temporal lobe function
Normal 17-18 (more sensitive to age and education)
Reflects integrity of DMN / semantic processing networks (MTL, posterior cingulate, anterior / lateral temporal
regions)
*Also may provide insight into executive control
LOONSTRA AS, TARLOW AR, SELLERS AH (2001). "COWAT METANORMS ACROSS AGE, EDUCATION, AND GENDER". APPL NEUROPSYCHOL. 8 (3): 161–6.
ARDILA, A.; OSTROSKY-SOLÍS, F.; BERNAL, B. (2006). "COGNITIVE TESTING TOWARD THE FUTURE: THE EXAMPLE OF SEMANTIC VERBAL FLUENCY (ANIMALS)". INTERNATIONAL JOURNAL OF
PSYCHOLOGY. 41 (5): 324–332.
21. LANGUAGE
A) Pointing: Ask for at least 4 objects or body parts.
B) Yes or No responses: ask at least 7 questions (eg. Is it a hotel? Is it a rainy day?
C) Complex Commands: The lion was killed by the tiger? Which animal is dead? The boy was slapped by
the girl? Who got hit?
22. LANGUAGE
Repetition
Airplane
Community Hospital
Ganga Jamuna Saraswati
Saraswati Shishu Bal Vidhya Mandir
Type of errors: Addition / Omission / Paraphasis / Grammatical
23. LANGUAGE
Naming and Word Finding
Color: Red, Blue, Yellow, Pink
Body Parts: Eye, Leg, Teeth, Thumb
Clothing and room objects: Door, Watch, Shoe, Shirt
Parts of Objects: Chain of a wrist watch, buckle of the belt, shoe laces, nib of a pen
Less than 4 in any category is abnormal
Impression:
24. LANGUAGE
Reading (Aloud)
Letters: G, D, E, Q, M, O, P, X, B, A
Numbers: 5, 8, 9, 6, 23, 59, 678, 321
Give a paragraph to read
Reading Comprehension (Ask something about a written sentence)
‘The boy and the girl walked in the sun’
Question: Did the boy go alone?
Question: Was it raining when the boy and the girl went for a walk?
38. WRITING
Please write the name of the object
Please write your name and address
Write the serial number from 11 to 20
Write what I say
Go
Come
Boy
Book
Door
39. CALCULATIONS
4 + 3 = ______ a) 8 b) 4 c) 9 d) 7
9 -5 = _______ a) 5 b) 3 c) 9 d) 4
5 – 2 = _______ a) 6 b) 3 c) 8 d) 4
4 x 2 = _______ a) 6 b) 8 c) 10 d) 12
6 x 3 = _______ a) 10 b) 18 c) 12 d) 14
9 / 3 = _______ a) 5 b) 6 c) 3 d) 9
30 / 5 = _______ a) 6 b) 8 c) 4 d) 10
45. MEMORY FUNCTION
Memory is receiving, processing, maintaining and retrieving information.
Registration (Encoding and Acquisition)
Retention(Storage or Consolidation)
Retrieval (Recall or Decoding)
Temporal stages of memory
Sensory
Immediate
Recent and
Remote
Three memory functions: Immediate recall, learning ability and retrieval.
46. MEMORY
Short-term Memory
AKA working memory, immediate memory
Ability to hold information across an undistracted delay
Prefrontal cortex
Long-term Memory
Memory not lost by distraction
Hippocampus and Papez circuit
Remote Memory
Memory of events many months ago
Semantic knowledge, procedural skill
Distributed in cortex, not dependent on hippocampus for retrieval.
47.
48. BUDSON AE, PRICE BH. MEMORY DYSFUNCTION. NEW ENGLAND JOURNAL OF MEDICINE. 2005 FEB 17;352(7):692-9.
49. A FILING ANALOGY OF EPISODIC MEMORY
BUDSON AE, PRICE BH. MEMORY DYSFUNCTION. NEW ENGLAND JOURNAL OF MEDICINE. 2005 FEB 17;352(7):692-9.
50. RECENT MEMORY
Left Temporal: verbal memory
Rey’s Auditory Verbal Learning test
UCLA Memory test
Paired Associate Learning Test
Right Temporal: Visual Memory
Benton Visual Memory Test
Hide 5 objects in front of patient and ask him after 5 minutes about the name and its location (< 4 abnormal).
52. PAIRED ASSOCIATIVE LEARNING TEST
Read the first presentation at the rate of one
pair every 2 seconds. After reading the first
presentation, test for recall by presenting the
first recall list. Give the first word of a pair and
allow 5 seconds for a response. If the patient
gives a correct response, say "That's right" and
proceed with the next pair. If the patient gives
an incorrect response, say "No," provide the
correct word, and proceed to the next pair.
After the first recall has been completed, allow
a la-second interval and give the second
presentation list, proceeding as before.
55. VERBAL EPISODIC MEMORY- “WORD LIST LISTENING’
Three-Step Process
Encoding: Processing information
“Repeat 3 words: X, Y, Z”
Storage: retain information over time
Retrieval: Access information
“What were the three words?”
If recall < 3, is it a storage or retrieval problem?
Retrieval deficit aided by clue or multiple choice.
56. SEMANTIC MEMORY
Semantic Memory
Historical facts
Independence day?
Who built Taj Mahal?
Name the colours in Indian flag
When do we celebrate Gandhi Jayanti
For Uneducated
Sita was wife of?
Who killed Ravan?
When do we celebrate Christmas?
63. RIGHT-LEFT DISORIENTATION
The following outline, which is in ascending order of difficulty, may be used to test for right-left disorientation.
TEST ITEMS
1. Identification on self
Show me your right foot.
Show me your left hand.
2. Crossed commands on self
With your right hand touch your left shoulder.
With your left hand touch your right ear.
3. Identification on examiner (with examiner facing patient)
Point to my left knee.
Point to my right elbow.
4. Crossed commands on examiner (with examiner facing patient)
With your right hand point to my left eye.
With your left hand point to my left foot.
Most normal persons will successfully accomplish all items without difficulty, although a significant percentage of the normal population
(9% of males and over 17% of females) has demonstrable difficulty on right-left testing.
64. FINGER AGNOSIA
Finger agnosia is the inability to recognize, name, and point to individual fingers on oneself and on others
TEST ITEMS
1. Nonverbal finger recognition
Directions: With the patient's eyes closed, touch one finger. Have the patient open his or her eyes and then
point to the same finger on the examiner's hand.
2. Identification of named fingers on examiner's hand
Directions: The examiner's hand should be placed in various positions (e.g., palm down on the table facing
the patient; hand held vertically in the air with the palm facing the patient; and hand held horizontally in the
air with the palm facing the examiner). The examiner should say "Point to my middle finger," and so forth.
3. Verbal identification (naming) of fingers on self and examiner
Directions: The patient's and examiner's hands should be placed in the various positions as described earlier.
The examiner points to the patient's index finger and says, ''What is the name of this finger?" and so forth.
67. TESTING FOR LIMB APRAXIA
1. Pantomime to verbal command
Transitive: Associated with tool or instrument use- demonstrate how to comb their hair, brush their teeth
or use a pair of scissors.
Intransitive: Associated with communicative gestures- demonstrate how to wave goodbye, beckon
somebody to come, say Namaste, Salute, victory sign.
Testing involves the right and left limbs independently.
Observes the patient’s responses for the presence of temporal- spatial or content errors.
If the patient has difficulty pantomiming movements- tests their ability to imitate gestures.
68. TESTING FOR LIMB APRAXIA
2. Imitation of Gestures
Performs both transitive and intransitive movements and asks the patient to copy the movements.
Also include meaningless / non-representational gestures such as interlocking circles made with the
thumb and index finger on each hand.
Disturbed meaningless gestures.
Either an inability to apprehend spatial relationships involving the hands and arms in parietal-variant
ideomotor apraxia.
Basic disturbances in idiokinetic movements.
69. TESTING FOR LIMB APRAXIA
3. Gesture Knowledge
Perform the same transitive and intransitive gestures and asks the patient to identify the gesture.
Patient must identify the gesture and discriminate between those that are well and poorly performed.
4. Sequential Actions
Patient must perform tasks that require several motor acts in sequence, such as making a sandwich or
preparing a letter for mailing.
5. Conceptual Knowledge
Patient is shown pictures of tools or objects or the actual tools or objects themselves.
The examiner then requests the patient to pantomime the action associated with the tool or object.
70. TESTING FOR LIMB APRAXIA
6. Limb Kinetic Movements
Examiner checks for fine finger movements by asking the patient to do repetitive tapping, picking up a
coin with a pincer grasp and twirling the coin.
7. Real Object Use
If limb apraxia is present, test with real object use.
Most limb apraxias improve when using real objects for transitive actions and when gesturing
spontaneously with intransitive actions.
Any impairment in the patient’s ability to use real objects indicates marked severity of the limb apraxia.
73. OBJECITVE EVALUTATION
Working Memory: Complex tasks like digit span backwards and trail making test part B.
Verbal Fluency: Letter fluency more closely associated than category fluency.
Design Fluency:
74. OBJECTIVE EVALUTATION
Motor Programming: Luria’s “Fist – edge - palm” test
Response Inhibition: “Go– no – go” test
Abstract Reasoning: Eg. Proverb Interpretation
75. REFERENCES
Bradley and Daroff’s Neurology in Clinical Practice, 8th Edition.
The Mental Status Examination in Neurology, Richard L. Strub, 4th Edition.
Budson, A. E., & Price, B. H. (2005). Memory dysfunction. New England Journal of Medicine, 352(7), 692-699.
Konstantopoulos, K., Vogazianos, P., & Doskas, T. (2016). Normative data of the Montreal Cognitive Assessment
in the Greek population and parkinsonian dementia. Archives of Clinical Neuropsychology, 31(3), 246-253.
Ardila, A., Ostrosky‐Solís, F., & Bernal, B. (2006). Cognitive testing toward the future: The example of Semantic
Verbal Fluency. International Journal of Psychology, 41(5), 324-332.
MacLeod, C. M., & MacDonald, P. A. (2000). Interdimensional interference in the Stroop effect: Uncovering the
cognitive and neural anatomy of attention. Trends in cognitive sciences, 4(10), 383-391.
Sustained attention (SA) is a vital function mediated by the right frontal - parietal cortex. The digit vigilance test (DVT) measures SA.
Duration: 7 to 10 minutes
Duration: 5 to 10 minutes
Default mode network
The original design is shown at the top, and after a delay, the four design choices are shown and the subject is asked to choose the one that best matches the original design.
If an acquired disorder of right-left orientation is present, the lesion is usually located in the parietotemporal-occipital region of the dominant hemisphere.
Patients with finger agnosia usually have lesions of the dominant hemisphere. Left- handed patients or those with strong family histories of left-handedness may exhibit finger agnosia with lesions of either hemisphere. Parietal-occipital lesions are the most likely to cause finger agnosia.
Complex set of abilities like volition, planning, purposive action and effective performance.