Podcast
Questions and Answers
Psychiatrists are unlikely to see patients with slow-growing brain tumours.
Psychiatrists are unlikely to see patients with slow-growing brain tumours.
False
Rapidly expanding brain tumours can present as delirium due to raised intracranial pressure.
Rapidly expanding brain tumours can present as delirium due to raised intracranial pressure.
True
Cognitive impairment after treatment of brain tumours is not a significant issue in children.
Cognitive impairment after treatment of brain tumours is not a significant issue in children.
False
Craniopharyngiomas are associated with personality changes and apathy.
Craniopharyngiomas are associated with personality changes and apathy.
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Only primary brain tumours can cause cognitive impairment in patients with cancer.
Only primary brain tumours can cause cognitive impairment in patients with cancer.
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Autoantibodies are a known cause of cognitive impairment in cancer patients.
Autoantibodies are a known cause of cognitive impairment in cancer patients.
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Metabolic derangements can contribute to cognitive impairment in cancer patients.
Metabolic derangements can contribute to cognitive impairment in cancer patients.
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Radiotherapy has no long-term effects on cognitive function.
Radiotherapy has no long-term effects on cognitive function.
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Psychiatric symptoms from brain tumours are solely influenced by their size.
Psychiatric symptoms from brain tumours are solely influenced by their size.
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Focal lesions in the brain can give rise to specific neuropsychiatric syndromes.
Focal lesions in the brain can give rise to specific neuropsychiatric syndromes.
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Neurosyphilis is a common manifestation in western countries today.
Neurosyphilis is a common manifestation in western countries today.
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An asymptomatic stage precedes clinical disease in neurosyphilis.
An asymptomatic stage precedes clinical disease in neurosyphilis.
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General paresis typically develops within two years of infection.
General paresis typically develops within two years of infection.
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Meningovascular syphilis can present with strokes and personality changes.
Meningovascular syphilis can present with strokes and personality changes.
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The occurrence of dementia in neurosyphilis is typically accompanied by psychotic symptoms.
The occurrence of dementia in neurosyphilis is typically accompanied by psychotic symptoms.
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Tabes dorsalis primarily affects psychiatric conditions.
Tabes dorsalis primarily affects psychiatric conditions.
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HIV infection is not associated with neurosyphilis.
HIV infection is not associated with neurosyphilis.
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Emotional lability can be a symptom of meningovascular syphilis.
Emotional lability can be a symptom of meningovascular syphilis.
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Study Notes
Intracranial Infections
- Intracranial infections can lead to cognitive impairments; treatment is often effective.
- Consider unusual infections as potential causes of unexplained cognitive and psychiatric symptoms.
- Types of infections include encephalitis and HIV, which are covered in separate chapters.
Neurosyphilis
- Caused by Treponema pallidum, neurosyphilis is uncommon in Western countries but rising in Eastern Europe and among those with HIV.
- Symptoms appear in neuropsychiatric patients; blood or CSF tests are recommended for diagnosis.
- Asymptomatic stages can precede clinical manifestations, with variable latencies.
- Forms of symptomatic neurosyphilis:
- Meningovascular syphilis: Occurs within 5 years of infection leading to strokes, personality changes, headaches, and possible dementia.
- General paresis: Develops around 20 years post-infection; causes dementia, personality changes, dysarthria, and may feature grandiose delusions.
- Tabes dorsalis: Involves degeneration of spinal cord pathways; less common in psychiatric settings.
Brain Tumours
- Brain tumours can significantly impact psychological health, often presenting with psychological symptoms.
- Slow-growing tumours in 'silent' areas (e.g., frontal lobe) may cause psychological effects without noticeable neurological signs.
- Symptoms are influenced by raised intracranial pressure and rate of tumour growth.
- Rapidly growing tumours can cause delirium; slower tumours may lead to chronic cognitive deficits.
- Specific neuropsychiatric syndromes arise from focal lesions, particularly near frontal poles, which may lead to personality changes.
- Tumours near the hypothalamus are associated with personality alterations and apathy.
- Cognitive impairments post-treatment for brain tumours, especially in children who received radiotherapy, are notable concerns.
Cognitive Impairments in Cancer
- Neoplasms can impair cognition through various mechanisms beyond direct brain tumour effects.
- Cognitive issues may arise during treatment or may present as initial symptoms.
- Common causes of cognitive impairment in cancer patients include:
- Mass effects: Primary and metastatic brain tumours, haemorrhagic changes, and meningeal conditions.
- Metabolic derangements: Conditions like hypercalcaemia, hyponatraemia, acidosis, and hypoglycaemia.
- Radiotherapy effects: Can lead to radionecrosis, cerebral atherosclerosis, and leucodystrophy.
- Chemotherapy: May cause metabolic encephalopathies and increase susceptibility to opportunistic infections.
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Description
Explore the impact of intracranial infections on cognitive functions and the importance of recognizing unusual infections. This quiz also covers the implications of neurosyphilis as a neurocognitive disorder linked to tertiary syphilis. Gain insights relevant to psychosomatic symptoms and treatment approaches.
