False: Alexia without agraphia usually accompanies infarction of the left occipital lobe following occlusion of the left posterior cerebral artery. Patients are able to comprehend words spelt aloud and also to write but they are quite unable to read. They cannot read even their own writing (Hodges 1994, p. 61; Lishman 1997, p. 19).

True: In Broca’s aphasia spontaneous speech is sparse, slow, non-fluent, effortful, dysarthric, dysprosodic, short in phrase length and agrammatical in the presence of relatively preserved comprehension, abnormal repetition and naming, and disturbed reading and writing (Mitchell 2004, p. 72; Yudofsky & Hales 2002, p. 568).

False: Pathological fear of blushing is called erythrophobia. Binswanger’s disease is a subcortical vascular dementia affecting the deep white matter of the brain (Lishman 1997, p. 458; Mitchell 2004, p. 46).

False: Although the EEG is almost always abnormal, the changes are usually variable and non-specific, especially in the early stages. Initially there may only be local or diffuse slowing. This may progress to paroxysmal sharp waves or slow spike and wave discharges. A characteristic pattern of 1–2-Hz periodic simple, biphasic, triphasic or polyspike sharp wave complexes on a slow background with loss of alpha rhythm occurs in 70–90% of cases late in the illness (Lishman 1997, p. 478; Sadock & Sadock 2005, p. 469).

True: Myoclonus is a muscular jerk that may be localized or diffuse. The differential diagnosis of dementia with myoclonus includes CJD, late stages of dialysis dementia, AIDS dementia and Alzheimer’s disease.

CJD is a rare cause of dementia and in its classical form myoclonus is often present. Parkinsonism and choreoathetoid movements may also be seen. New variant CJD may show similar movement disorders but is also accompanied by sensory problems including painful neuropathy (Mitchell 2004, p. 16; Wright et al 2005, p. 387).

False: The alpha rhythm is best recorded over the occipital and parietal region. It occurs during wakefulness on eye closure and attenuates on eye opening (Yudofsky & Hales 2002, p. 45).

False: During epileptic automatisms consciousness is clouded but not completely lost. Hence, seizure activity may not be immediately obvious. Stereotyped movements (e.g. lip smacking) may occur. More complex behaviour is seen more rarely. The EEG shows initial low voltage theta waves and later, bilateral delta waves (Wright et al 2005, p. 395).

True: Flexibilitas cereas or waxy flexibility was associated with encephalitis lethargica. Although an aetiological agent was never identified, the onset and course of the disease was consistent with encephalitis (Lishman 1997, p. 349).

False: Exons are the coding regions. At no point are they excluded. The process of replication involves transcription of DNA to mRNA, splicing out of introns and then translation of mRNA to protein (Puri & Tyrer 1998, p. 171).

True: During the polymerase chain reaction the double helix of DNA needs to be separated to allow replication of a DNA sequence. This separation is facilitated by heating the DNA. A special thermostable DNA polymerase which will not be denatured by heat is therefore required (Alberts et al 2000, p. 508).

False: Disinhibition is more typical after frontal lesions, especially those involving the orbito-frontal areas (Mitchell 2004, p. 136).

True: Individuals may present themselves for testing in states of severe distress and alarm. This is called AIDS anxiety or AIDS panic (Lishman 1997, p. 331).

True: The prevalence of manic syndromes in AIDS patients is more than 10 times that in the general population. AIDS mania is a secondary mania consequent to brain HIV involvement. This is associated with late stage HIV infection, cognitive impairment and absence of previous episodes or family history of bipolar affective disorder. AIDS mania is usually quite severe in its presentation and the course is often chronic rather than episodic. They may develop a delusion that their HIV has been cured and this can interfere with treatment. They are also more sensitive to the side-effects of psychotropic medication (Gelder et al 2000, p. 1170; Mitchell 2004, p. 189; Sadock & Sadock 2005, p. 437).

True: Anticipation phenomenon means that each successive generation tends to develop Huntington’s disease at an earlier age than the previous one. This is more marked with paternal inheritance. The paternally derived gene may be more unstable than those from the maternal line and this leads to an expanded number of repeats in the next generation. This in turn leads to earlier clinical manifestation (Yudofsky & Hales 2002, p. 332).

True: In the early phases, memory decline is almost imperceptible, but gradually accelerates to an average of 3 points or more on the MMSE per year (Mitchell 2004, p. 427).

True: Cognitive impairment is present in 40% of community samples and 50–60% of clinic attenders. It may present early in the illness and becomes more common as the disease progresses. Neuropsychological deficits may be evident even before the full diagnosis of multiple sclerosis is made, for example when the only symptoms are those of optic neuritis (Gelder et al 2006, p. 353; Lishman 1997, p. 693; Mitchell 2004, p. 145).

False: Narcolepsy is characterized by a tetrad of symptoms:

The prevalence of narcolepsy is between 3 and 6 per 100 000. Cataplexy is the temporary loss of muscle tone precipitated by emotions such as anger and laughter. The severity of cataplexy ranges widely from transient weakness of the knees to total paralysis while the patient is fully conscious. Usually the patient is unable to speak and may fall to the floor. Episodes may last from several seconds to minutes. Cataplexy occurs only in 60–70% of those with narcolepsy. Hence, the prevalence of narcolepsy with catalepsy would be approximately 0.3 per 10 000 (Fear 2004, p. 328).

True: Nominal dysphasia, amnesic aphasia or anomic aphasia, is the commonest form of aphasia, but the least well understood. It involves difficulties in evoking names at will. Mild forms of nominal aphasia may be caused by diffuse brain dysfunction due to toxic or degenerative conditions. Nominal aphasia may also be caused by focal brain lesions, especially by dominant temporo-parietal lesions in the neighbourhood of the angular gyrus. Nominal aphasia is often associated with acalculia and other components of Gerstmann syndrome (Lishman 1997, p. 52).

False: Poeck in 1969 described the features of pathological laughing and crying as:

True: Prosopagnosia is the inability to recognize the identities of previously well-known faces and to learn new ones. Exposure to the voice of the unrecognized individual will elicit prompt recognition. It is associated with damage to the temporo-occipital junction or bilateral damage to the ventral aspect of the occipital lobes (Yudofsky & Hales 2002, p. 81).

True: In systemic lupus erythematosis, depression starts gradually, lasts several weeks or months and resolves slowly (Lishman 1997, p. 420).

True: Most cases of obstructive sleep apnoea occur in males after the age of 40. Central sleep apnoea can affect all age groups (Lishman 1997, p. 730).

True: Night terror is characterized by a sudden incomplete arousal from sleep with intense fearfulness. The individual typically sits in bed, is unresponsive to stimuli, and if awakened is confused or disorientated. There is often amnesia for the episode. These episodes arise from slow wave sleep. Psychopathology is seldom associated with night terrors in children. However, adults with night terrors often have psychiatric problems or a history of traumatic experiences. The frequency ranges from less than once per month to almost every night (Yudofsky & Hales 2002, p. 717).

False: Nominal aphasia refers to difficulties with language function manifest as problems with word finding and naming. Temporal lobe damage can affect semantic memory. Difficulty with vocabulary may result in severe anomia and semantic dementia. Such deficits are most commonly associated with dominant lobe lesions. Non-dominant lesions impair appreciation of music. Dominant lobe lesions are also associated with Wernicke’s dysphasia (Hodges 1994, p. 44).

False: Haloperidol, sulpiride and pimozide are the most commonly used, but there is no good evidence that suggests any particular drug has superior efficacy (Mitchell 2004, p. 359).