Higher functions

1- Aphasia:

A- Broca’s aphasia:

* It is usually associated with right hemiplegia, orofacial apraxia and possibly an ideomotor apraxia.

* It is the result of an interesting ischemic left hemisphere; it interests Broca’s area: sup ⅓ of the third left frontal convolution

* The lesions involving subcortical internal capsule are enough to determine the symptomatology of Broca’s aphasia.

* If the lesions involve the entire MCA territory, very severe disorders of understanding can be combined (total aphasia)

B- Wernicke aphasia:

* Lack of hemiplegia; hemianopia often associated namesake right

* Cortical lesions involving the associative auditory cortex (post part of the first temporal gyrus) and the cortex of the parietal lobule inf

* Temporal Variety: predominantly disorders of understanding and expression of oral language

* Parietal Form: written language disorders are predominant: aphasic alexia, agraphia and acalculie.

* Forced grasping observed in frontal lesions manifest liberated activity of parietal devices. This is opposite to avoidance is found in lesions in the parietal cortex.

* The frontal lobe is opposed to stereotypes, control selection, maintaining the primacy of the selection.

2- Apraxia:

A- Melo-kinetics:

Disruption elementary movement; decreased motor spontaneity (motor neglect) and prevalence of tonic formulas (grip; avoidance)

B- Ideo-motor:

Manifested in the actions not involving the use of an object: the patient is unable to carry on military hi order.

perfect execution if automatic evocation …

C- Ideational:

Occurs when using an object: can not write with a pencil; does not know lighting a candle …

D- Constructive:

graphic activity; and spatial relations

Dominance of the left hemisphere (parietal and frontal)

3- Agnosia:

A- Syndrome Anton-Babinski:

* Anosognosia hemiplegia and hémiasomatognosie

* Denotes lesions minor hemisphere parietal

* Other: hémicorps negligence; indifference to the disorder that strikes (anosodiaphoria)

B- Gerstmann:

* By reaching the parietal dominant hemisphere (left)

* Loss of differentiated knowledge of fingers

* Left-right indistinction

* Agraphie and acalculie

C- Autotopoagnosie:

* Is the loss of the ability to appoint ordered orally body parts

* By reaching the dominant hemisphere

D- Constructive:

graphic activity; and spatial relations

* Alteration of the parietal region of the minor hemisphere seriously compromises the integration of the contralateral side of the body in the image of the body, but the activity of the dominant hemisphere is enough to keep in consciousness the notion of a organized body.

* The alteration of the dominant hemisphere is marked by disruptions that focus on body awareness …

* The agnosia prosopagnosia or face is usually the result of bilateral lesions of the temporo-occipital border.

The role of the right hemisphere is dominant for identifying the specificity of faces.

Note:

The sign of Souques eyelashes shows a deficit of orbicularis oculi; it is evidenced in the strong eye closure => eyelashes are much more apparent on the paralyzed side -> crude form.