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is dementia. Specific parts of the cerebral hemisphere are responsible for a certain aspect of function. In normal circumstances these functions are integrated and the patient operates as a whole. Damage to part of the cortex will result in a characteristic disturbance of function. Interruption by disease of connections between one part of the cortex and another will disconnect function Right and left hemisphere Unilateral brain damage reveals a difference in function between hemispheres. The left hemisphere is dominant in right handed people Left hemisphere is dominant in majority of left handed [upto 75%]
Frontal lobe function Movement contralateral body [face, arm/leg, trunk] Speech dominant Personality Bladder and bowel control Impairment Hemiplegia Aphasia Change in personality with antisocial behavior and loss of inhibition Primitive reflexes e.g. grasp, pout etc. Gait apraxia Incontinence
comprehension.apraxia [patient cannot find his bed in the ward] Cannot copy geometrical patters – constructional apraxia Homonoypos quadtrantonopia .calculation Non-dominant Body image Awareness of external enviornmement Ability to construct shapes Impairment [Either dominant or non-dominant] Contralateral Postural senses Sensation of passive movement Accurate localization of light touch 2 point discrimination [4m on finger tips] appreciation of size.Parietal lobe function Appreciation of posture. touch and passive movement Dominant hemisphere Language. texture and weight – asteriognosis Wernickes dysphasia Dominant Confusion of right and left limbs Difficulty in distinguishing fingers Disturbance of calculation – acalculia Disturbance of writing – agraphia Non dominant No longer aware of opposite limbs -ansognosia Difficulty in dressing – dressing apraxia Disturbance of geographical memory – geo. shape. Wernickes Handling numbers.
rhythms and music Learning and memory Limbic –olfaction.emotion and affective behavior Impairment Deafness bilateral lesions -complete deafness .patient may be unaware Memory and learning Aggressive and antisocial behavior Upper homonypous quandtranopia Wernickes dysphasia dominant Occipital lobe function Perception of vision Impairment Blindness .extensive bilateral lesion .Parietal lobe function Auditory Dominant-hearing of language Non-dominant – hearing of sounds.
Dementia Dementia may occur at any age More common in the elderly Annual incidence rate 187/100000 Dementia is a symptom of disease rather than a single disease entity < 65yrs pre-senil dementia It is generally irreversible and develops in association with a normal level of conciousness The incidence increases with age Many conditions are associated with the development of dementia Assessment .