Chapter 14. Higher Cortical Function Disorders. Emotional and Behavioral Disorders
5 topics with brief reviews: definitions, key facts, and class questions.
Welcome to one of the most complex and fascinating sections of neurology, exploring the cognitive foundation of the human mind. Here, we analyze how and why the brain loses its higher functions: speech, recognition, memory, and intellect.
This chapter provides a detailed breakdown of classic focal syndromes (aphasia, agnosia, amnesia), as well as the total decay of cognitive functions—dementia. Special attention is given to emotional and behavioral disorders, which frequently accompany organic lesions of the nervous system and radically alter the patient's personality.
During practical classes and exams, you will most often be asked to differentiate types of aphasias (especially Broca's motor and Wernicke's sensory aphasia), distinguish age-related memory decline from fully developed dementia, and correlate symptoms with the topography of cerebral cortex lesions. Study thoughtfully: accurate topical diagnosis is impossible without this knowledge.
Writing and reading are higher cognitive functions supported by the same association cortical areas as spoken language.
How does agnosia differ from anesthesia?
In anesthesia, sensation itself is impaired (the signal does not reach). In agnosia, sensation is preserved, but the brain cannot properly process and recognize the received signal.
What is the main difference between mild cognitive impairment and dementia?
In mild cognitive impairment, patients fully retain their ability to work and independence in daily life despite clear memory problems. In dementia, daily and social adaptation is lost, and the patient requires outside assistance.
What is the difference between an illusion and a hallucination?
Hallucinations occur in the complete absence of a real stimulus. Illusions, on the other hand, are distorted perceptions of a real object or stimulus.
What should be done if clinical symptoms are present, but screening shows no impairments?
The detection of any signs of higher cortical function impairment, even with normal screening results, is a direct indication for referring the patient for a specialized neuropsychological examination using advanced tests.
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