Textbook of clinical neuropsychiatry, 2. ed

PART I DIAGNOSTIC ASSESSMENT 1 1 Diagnostic assessment 3 1.1 Diagnostic interview 3 1.2 Mental status examination 5 1.3 Neurologic examination 10 1.4 Neuroimaging 17 1.5 Electroencephalography 21 1.6 Lumbar puncture 31 PART II SIGNS, SYMPTOMS, AND SYNDROMES 43 2 ‘Cortical’ signs and symptoms 45 2.1 Aphasia 45 2.2 Alexia 49 2.3 Agraphia 50 2.4 Acalculia 51 2.5 Gerstmann’s syndrome 51 2.6 Hypergraphia 52 2.7 Aprosodia 53 2.8 Apraxia 55 2.9 Agnosias 57 2.10 Neglect 62 3 Abnormal movements 72 3.1 Tremor 72 3.2 Myoclonus 75 3.3 Motor tics 77 3.4 Chorea 78 3.5 Athetosis 81 3.6 Ballism 82 3.7 Dystonia 83 3.8 Parkinsonism 87 3.9 Akinesia 91 3.10 Akathisia 92 3.11 Catatonia 93 3.12 Asterixis 96 3.13 Mirror movements 97 3.14 Pathologic startle 98 4 Other signs and symptoms 117 4.1 Mutism 117 4.2 Akinetic mutism 118 Contents Preface xiii viii Contents 4.3 Stuttering 119 4.4 Palilalia 120 4.5 Perseveration 121 4.6 Primitive reflexes 121 4.7 Pseudobulbar palsy 123 4.8 Emotional facial palsy 124 4.9 Le fou rire prodromique 125 4.10 Abulia 125 4.11 Environmental dependency syndrome 126 4.12 Kluver–Bucy syndrome 127 4.13 Alien hand sign 129 4.14 Balint’s syndrome 131 4.15 Phantom and supernumerary limbs 131 4.16 Depersonalization 132 4.17 Obsessions and compulsions 133 4.18 Reduplicative paramnesia 135 4.19 Confabulation 136 4.20 Amusia 136 4.21 Foreign accent syndrome 137 4.22 Cataplexy 137 4.23 Sympathetic storm 138 4.24 Catastrophic reaction 139 4.25 Flattened affect 139 4.26 Inappropriate affect 139 4.27 Mannerisms 140 4.28 Stereotypies 140 4.29 Echolalia and echopraxia 141 4.30 Hallucinations and delusions 142 4.31 Schneiderian first rank symptoms 146 5 Syndromes of cognitive impairment 162 5.1 Dementia 162 5.2 Mild cognitive impairment 173 5.3 Delirium 174 5.4 Amnesia 183 5.5 Mental retardation 187 6 Syndromes of disturbances of mood and affect 208 6.1 Depression 208 6.2 Apathy 214 6.3 Mania 215 6.4 Agitation 222 6.5 Anxiety 225 7 Other major syndromes 238 7.1 Psychosis 238 7.2 Personality change 244 7.3 Seizures and epilepsy 249 7.4 Stroke 275 7.5 Traumatic brain injury 288 7.6 Acute encephalitis 294 7.7 Somatoform disorders 296 7.8 Malingering and factitious illness 302 PART III SPECIFIC DISORDERS 333 8 Neurodegenerative and movement disorders 335 8.1 Alzheimer’s disease 335 8.2 Pick’s disease 340 8.3 Frontotemporal dementia 341 lims.qxd 3/10/08 5:51 PM Page viii Contents ix 8.4 Amyotrophic lateral sclerosis 342 8.5 Parkinson’s disease 344 8.6 Diffuse Lewy body disease 350 8.7 Progressive supranuclear palsy 352 8.8 Corticobasal ganglionic degeneration 354 8.9 Multiple system atrophy 354 8.10 Huntington’s disease 356 8.11 Choreoacanthocytosis 358 8.12 FXTAS 358 8.13 Senile chorea 359 8.14 Benign hereditary chorea 360 8.15 Dentatorubropallidoluysian atrophy 360 8.16 Wilson’s disease 361 8.17 Spinocerebellar ataxia 362 8.18 Pantothenate kinase-associated neurodegeneration 364 8.19 Dopa-responsive dystonia 365 8.20 Primary torsion dystonia 366 8.21 Idiopathic cervical dystonia 366 8.22 Task-specific dystonia 367 8.23 Meige’s syndrome 368 8.24 Spasmodic dysphonia 368 8.25 Tourette’s syndrome 369 8.26 Myotonic muscular dystrophy 371 8.27 Cerebrotendinous xanthomatosis 373 8.28 Thalamic degeneration 374 8.29 Metachromatic leukodystrophy 374 8.30 Adrenoleukodystrophy 376 8.31 Kufs’ disease 377 8.32 Essential tremor 377 8.33 Hyperekplexia 378 9 Congenital, developmental, and other childhood-onset disorders 403 9.1 Sturge–Weber syndrome 403 9.2 Tuberous sclerosis 404 9.3 Von Recklinghausen’s disease (neurofibromatosis type 1) 405 9.4 Down’s syndrome 407 9.5 Klinefelter’s syndrome 408 9.6 Fragile X syndrome 409 9.7 Velocardiofacial syndrome 410 9.8 Lesch–Nyhan syndrome 411 9.9 Bardet–Biedl syndrome 412 9.10 Prader–Willi syndrome 412 9.11 Congenital rubella syndrome 413 9.12 Fetal alcohol syndrome 414 9.13 Rett’s syndrome 414 9.14 Autism 416 9.15 Attention-deficit/hyperactivity disorder 418 9.16 Developmental dysphasia 420 9.17 Developmental dyslexia 421 9.18 Developmental dysgraphia 422 9.19 Developmental dyscalculia 423 9.20 Developmental stuttering 423 10 Vascular disorders 433 10.1 Multi-infarct dementia 433 10.2 Lacunar dementia 434 10.3 Vascular parkinsonism 435 10.4 Binswanger’s disease 436 10.5 Cranial arteritis 437 lims.qxd 3/10/08 5:51 PM Page ix x Contents 10.6 Cerebral amyloid angiopathy 438 10.7 CADASIL 439 10.8 Granulomatous angiitis of the central nervous system 440 10.9 Polyarteritis nodosa 441 10.10 Wegener’s granulomatosis 442 10.11 Behçet’s disease 442 10.12 Hypertensive encephalopathy 443 10.13 Reversible posterior leukoencephalopathy syndrome 444 10.14 MELAS 445 10.15 Thrombotic thrombocytopenic purpura 446 10.16 Fat embolism syndrome 446 10.17 Multiple cholesterol emboli syndrome 447 10.18 Transient global amnesia 447 11 Trauma 454 11.1 Subdural hematoma 454 11.2 Diffuse axonal injury 455 11.3 Dementia pugilistica 456 11.4 Post-concussion syndrome 457 11.5 Radiation encephalopathy 458 12 Hypoxic disorders 462 12.1 Post-anoxic encephalopathy 462 12.2 Delayed post-anoxic leukoencephalopathy 463 12.3 Carbon monoxide poisoning 463 13 Nutritional, toxic and metabolic disorders 466 13.1 Vitamin B12 deficiency 466 13.2 Folic acid deficiency 468 13.3 Pellagra 468 13.4 Wernicke’s encephalopathy 469 13.5 Korsakoff’s syndrome 471 13.6 Manganism 472 13.7 Thallium intoxicaton 473 13.8 Arsenic intoxication 473 13.9 Bismuth intoxication 474 13.10 Tin intoxication 474 13.11 Lead encephalopathy 475 13.12 Mercury intoxication 476 13.13 Dialysis dementia 476 13.14 Dialysis disequilibrium syndrome 477 13.15 Hypoglycemia 478 13.16 Hyperviscosity syndrome 479 13.17 Central pontine myelinolysis 479 13.18 Uremic encephalopathy 481 13.19 Hepatic encephalopathy 481 13.20 Acquired hepatocerebral degeneration 482 13.21 Hepatic porphyria 483 13.22 Fahr’s syndrome 484 14 Infectious and related disorders 493 14.1 Acquired immunodeficiency syndrome (AIDS) 493 14.2 Cytomegalovirus encephalitis 495 14.3 Progressive multifocal leukoencephalopathy 496 14.4 Arbovirus meningoencephalitis 497 14.5 Herpes simplex encephalitis 498 14.6 Encephalitis lethargica 499 14.7 Infectious mononucleosis 500 14.8 Mumps 501 14.9 Varicella-zoster 502 14.10 Rabies 503 lims.qxd 3/10/08 5:51 PM Page x Contents xi 14.11 Acute disseminated encephalomyelitis 504 14.12 Subacute sclerosing panencephalitis 506 14.13 Subacute measles encephalitis 506 14.14 Progressive rubella panencephalitis 507 14.15 Neurosyphilis 508 14.16 Lyme disease 510 14.17 Tuberculosis 512 14.18 Whipple’s disease 513 14.19 Rocky Mountain spotted fever 514 14.20 Malaria 514 14.21 Toxoplasmosis 515 14.22 Fungal infections 516 15 Prion diseases 525 15.1 Creutzfeldt–Jakob disease 525 15.2 New-variant Creutzfeldt–Jakob disease 527 15.3 Gerstmann–Sträussler–Scheinker disease 528 15.4 Fatal familial insomnia 528 15.5 Kuru 529 16 Endocrinologic disorders 534 16.1 Cushing’s syndrome 534 16.2 Adrenocortical insufficiency 536 16.3 Hyperthyroidism 537 16.4 Hypothyroidism 539 17 Immune-related disorders 544 17.1 Multiple sclerosis 544 17.2 Systemic lupus erythematosus 548 17.3 Sjögren’s syndrome 551 17.4 Sneddon’s syndrome 552 17.5 Primary anti-phospholipid syndrome 552 17.6 Susac’s syndrome 553 17.7 Limbic encephalitis 553 17.8 Sarcoidosis 555 17.9 Hashimoto’s encephalopathy 556 17.10 Sydenham’s chorea 558 17.11 Chorea gravidarum 560 18 Sleep disorders 569 18.1 Somnambulism 569 18.2 REM sleep behavior disorder 570 18.3 Nightmare disorder 572 18.4 Night terrors 572 18.5 Nocturnal head banging 573 18.6 Enuresis 574 18.7 Narcolepsy 575 18.8 Sleep apnea 577 18.9 Pickwickian syndrome (obesity–hypoventilation syndrome) 579 18.10 Kleine–Levin syndrome 579 18.11 Restless legs syndrome 581 18.12 Periodic limb movements in sleep 582 18.13 Painful legs and moving toes 583 18.14 Circadian rhythm sleep disorder 584 18.15 Primary insomnia 585 18.16 Primary hypersomnia 587 19 Brain tumors and hydrocephalus 596 19.1 Brain tumors 596 19.2 Hydrocephalus 600 19.3 Normal pressure hydrocephalus 602 lims.qxd 3/10/08 5:51 PM Page xi xii Contents 20 Idiopathic psychotic, mood, and anxiety disorders 606 20.1 Schizophrenia 606 20.2 Schizoaffective disorder 614 20.3 Delusional disorder 615 20.4 Post-partum psychosis 617 20.5 Bipolar disorder 618 20.6 Major depressive disorder 624 20.7 Premenstrual dysphoric disorder 629 20.8 Post-partum depression 630 20.9 Post-partum blues 631 20.10 Panic disorder 631 20.11 Agoraphobia 634 20.12 Specific (simple) phobia 635 20.13 Social phobia 636 20.14 Obsessive–compulsive disorder 638 20.15 Post-traumatic stress disorder 639 20.16 Generalized anxiety disorder 641 21 Substance use disorders 656 21.1 Stimulants 656 21.2 Cocaine 657 21.3 Hallucinogens 659 21.4 Phencyclidine and ketamine 660 21.5 Alcohol 661 21.6 Sedatives, hypnotics, and anxiolytics 667 21.7 Inhalents (solvents) 669 21.8 Cannabis 670 21.9 Opioids 671 21.10 Nicotine 673 21.11 Caffeine 675 21.12 Methanol 675 21.13 Isopropanol 676 22 Medication and substance-induced disorders 683 22.1 Neuroleptic malignant syndrome 683 22.2 Tardive dyskinesia 685 22.3 Supersensitivity psychosis 688 22.4 Rabbit syndrome 689 22.5 Serotonin syndrome 689 22.6 Anticholinergic delirium 690 22.7 Cholinergic rebound 691 22.8 Alcoholic dementia 692 22.9 Alcohol hallucinosis 693 22.10 Alcoholic paranoia 694 22.11 Marchiafava–Bignami disease 694 22.12 Inhalent-induced dementia