scholarly journals The role of neuropsychological examination in the diagnosis and treatment of adult patients with epilepsy

2021 ◽  
Vol 21 (1) ◽  
pp. 24-29
Author(s):  
Magdalena Gugała-Iwaniuk ◽  
Ksenia Sławińska
Keyword(s):  
Neuropsychological Assessment ◽  
Psychosocial Functioning ◽  
Emotional State ◽  
Emotional Functioning ◽  
Neuropsychological Examination ◽  
Neuropsychological Profile ◽  
Neurological Patients ◽  
Neurosurgical Treatment ◽  
Postsurgical Outcomes ◽  
Patients With Epilepsy

Individuals with epilepsy may experience various difficulties in cognitive and emotional functioning. The neuropsychological examination plays a significant role in the diagnosis and management of patients with epilepsy. It should be conducted by psychologists with appropriate competencies and experience, preferably by specialists who have undergone dedicated training in clinical psychology and gained clinical experience with neurological patients. Conclusions from neuropsychological examination provide information about the influence of epilepsy on cognitive and behavioral functioning of the patient. Neuropsychological assessment enables delineating the neuropsychological profile, including the description of the type and level of cognitive deficits, as well as examining the emotional state and psychosocial functioning of patients. Neuropsychological evaluation plays an important part in qualifying patients with epilepsy for neurosurgical treatment, and helps in the process of monitoring the state of patients in terms of postsurgical outcomes. In this paper, the authors present the aims of neuropsychological assessment in patients with epilepsy. Various factors are listed that can affect the profile of cognitive and emotional functioning of patients during the examination. On the basis of guidelines formulated by experts of the International League Against Epilepsy, the indications for neuropsychological examination are described, and the core cognitive and emotional dimensions that should be evaluated are presented. A list of psychometric tests and clinicalexperimental tasks addressing cognitive functions as well as a selection of tools assessing the emotional state that are available and used in Poland are also provided.

scholarly journals Classical galactosemia: neuropsychological and psychosocial functioning beyond intellectual abilities

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Mendy M. Welsink-Karssies ◽  
Kim J. Oostrom ◽  
Merel E. Hermans ◽  
Carla E. M. Hollak ◽  
Mirian C. H. Janssen ◽  
...  
Keyword(s):  
Cognitive Functioning ◽  
Social Functioning ◽  
Internalizing Problems ◽  
Psychosocial Functioning ◽  
Cognitive Test ◽  
Large Variability ◽  
Classical Galactosemia ◽  
Cognitive Domains ◽  
Neuropsychological Profile ◽  
Intellectual Abilities

Abstract Background Despite early diagnosis and treatment, Classical Galactosemia (CG) patients frequently develop long-term complications, such as cognitive impairment. Available literature primarily reports on general intellectual abilities and shows a substantially lower Full Scale Intelligence Quotient (FSIQ) in CG patients than in the general population. Both problems in social functioning as well as internalizing problems are often reported in CG patients. The combination of intelligence, cognitive functioning, behavior and social functioning has not been studied systematically in CG patients. Methods To determine if CG patients demonstrate a specific neuropsychological and psychosocial profile, we investigated intelligence, functioning on multiple cognitive domains, behavior and social functioning with a comprehensive neuropsychological test battery and questionnaires (self- and proxy-reported). Results The data of 48 patients, aged 4–47 years are reported. FSIQ ranged from 45 to 103 (mean 77 ± 14). A negative correlation between age and FSIQ was demonstrated (p = 0.037) which resulted directly from the inclusion of four young ‘milder’ patients detected by newborn screening (NBS) with an expected better clinical outcome. Compared to normative data, patients had significantly lower but highly variable scores on all cognitive domains, especially on tests requiring mental speed. In the context of the FSIQ, 43% of the cognitive test results exceeded IQ based expectations. Overall, the patients’ scores on social functioning were in the normal range but internalizing problems were frequently reported. In our cohort, an early initiation of dietary treatment due to NBS or family screening did not result in a more favorable neuropsychological outcome. Conclusions In this study, we demonstrated that as a cohort, CG patients have a below average intelligence and impaired cognitive functioning without a distinctive neuropsychological profile. The effect of age on neurocognitive functioning should be assessed in longitudinal studies. Social functioning was not impaired, but patients may be at risk for internalizing problems. Considering the large variability in cognitive, behavioral and social functioning and the finding that cognitive outcomes may exceed IQ based expectations, an individual evaluation and follow-up is warranted in all CG patients to ensure timely support if needed.

scholarly journals Executive Functions and Attention in Childhood Epilepsies: A Neuropsychological Hallmark of Dysfunction?

2020 ◽  
pp. 1-13
Author(s):  
Elisa Cainelli ◽  
Jacopo Favaro ◽  
Pietro De Carli ◽  
Concetta Luisi ◽  
Alessandra Simonelli ◽  
...  
Keyword(s):  
Executive Functions ◽  
Cognitive Skills ◽  
Multilevel Models ◽  
Statistical Significance ◽  
Illness Duration ◽  
Neuropsychological Profile ◽  
Ameliorative Effect ◽  
Neuropsychological Functions ◽  
Patients With Epilepsy ◽  
Over Time

Abstract Objective: Patients with epilepsy are at risk for several lifetime problems, in which neuropsychological impairments may represent an impacting factor. We evaluated the neuropsychological functions in children suffering from three main epilepsy categories. Further, we analyzed the longitudinal evolution of the neuropsychological profile over time. Methods: Patients undergoing neuropsychological evaluation at our Department from 2012 to 2018 were identified retrospectively. We selected patients aged 6–16 years and with at least two evaluations. Three epilepsy categories were considered: focal/structural, focal self-limited, and idiopathic generalized. Each evaluation included the same structured assessment of main neuropsychological domains. The effect of the epilepsy category, illness duration, seizure status, and medication was computed in multilevel models. Results: We identified 103 patients (focal self-limited = 27; focal/structural = 51; and idiopathic generalized = 25), for 233 evaluations. The majority of deficits were reported in attention and executive functions (>30% of patients); the results were dichotomized to obtain global indexes. Multilevel models showed a trend toward statistical significance of category of epilepsy on the global executive index and of illness duration on global attention index. Illness duration predicted the scores of executive and attention tasks, while category and medication predicted executive task performance. Focal/structural epilepsies mostly affected the executive domain, with deficits persisting over time. By contrast, an ameliorative effect of illness duration for attention was documented in all epilepsies. Conclusions: This study offers lacking information about the evolution of deficits in time, the role of epilepsy category, and possible psychological implications for high-order cognitive skills, central in several social and academic problems.

scholarly journals A-091 Neuropsychological findings in a Pediatric Case of Rhombencephalosynapsis

2020 ◽  
Vol 35 (6) ◽  
pp. 884-884
Author(s):  
Engelmann M ◽  
Austin C ◽  
Benjaminov A ◽  
Okoro A
Keyword(s):  
Emotional Functioning ◽  
Neuropsychological Testing ◽  
Aqueductal Stenosis ◽  
Fine Motor ◽  
Motor Deficits ◽  
Social Emotional ◽  
Social And Emotional ◽  
Neuropsychological Profile ◽  
Social Difficulties ◽  
Neuropsychological Findings

Abstract Objective Rhombencephalosynapsis (RES) is a rare cerebellar malformation resulting in agenisis/hypogenesis of the vermis. The main clinical features include truncal and/or limb ataxia, neuro-ophthalmological abnormalities, hydrocephalus, and dysmorphic signs, as well as difficulties with attention and emotional/behavioral regulation. This case contributes to the RES literature by providing a pediatric neuropsychological profile of RES with features of Gomez-Lopez-Hernandez syndrome (GLHS) alongside imaging and comparison with related syndromes (e.g. GLHS, Autism, Cerebellar Cognitive Affective Syndrome (CCAS), ADHD). Method The patient is a 12-year-old male with a complex medical history including hydrocephalus, strabismus, gross/fine motor delays, and bilateral alopecia. Psychiatric history includes anxiety, depression, mood lability, and social difficulties. Incidental imaging findings of rhombencephalosynapsis were found during Neurology consult. Imaging showed stable ventriculomegaly, aqueductal stenosis, and low lying cerebellar tonsils. A comprehensive neuropsychological evaluation was completed to assist with treatment recommendations. Results Neuropsychological testing demonstrated above average intellectual/reasoning abilities, with relative weaknesses (base rate difference < 5%) in attention, working memory, and processing speed. Primary deficits in shifting/flexibility within executive functioning tasks and social/emotional functioning, including rigidity of expectations, poor perspective taking, and all-or-nothing characterization of people and events. Fine motor deficits were also observed. Conclusions The RES literature is sparse, particularly for pediatric cases with average or better intellectual functioning. This case study provides concurrent neurological and neuropsychological findings which have been implicated in related conditions with cerebellar abnormalities, particularly the a) absence of the vermis and associated emotional lability and b) executive deficits of shifting/flexibility affecting cognitive, social, and emotional functioning.

scholarly journals Clinical and neuropsychological assessment of attention and ADHD comorbidity in a sample of children and adolescents with idiopathic epilepsy

2015 ◽  
Vol 73 (2) ◽  
pp. 96-103 ◽  
Author(s):  
Celia Regina Carvalho Machado da Costa ◽  
Guilherme de Macêdo Oliveira ◽  
Marleide da Mota Gomes ◽  
Heber de Souza Maia Filho
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Clinical Characteristics ◽  
Pediatric Patients ◽  
Idiopathic Epilepsy ◽  
Healthy Controls ◽  
Adhd Diagnosis ◽  
Hyperactivity Disorder ◽  
Neuropsychological Profile ◽  
Patients With Epilepsy

Children with epilepsy present significant problems concerning attention and comorbidity with attention deficit hyperactivity disorder (ADHD). Objective To determine the prevalence of attention complaints, ADHD diagnosis and attention profile in a sample of children and adolescents with idiopathic epilepsy. Method 36 children and adolescents with idiopathic epilepsy and 37 genre and age matched healthy controls underwent several procedures to diagnose their neuropsychological profile and comorbidity with ADHD. Results The prevalence of ADHD was higher in patients with epilepsy [χ2= 4.1, p = 0.043, 6 (16.7%) vs 1 (2.7%)], with worse results in attention related WISC items and factors in patients with epilepsy comparing to the controls, but not between patients with and without ADHD. Clinical characteristics did not influence those results. Conclusion This study found a greater prevalence of problems wih attention in pediatric patients with idiopathic epilepsy, but not a distinct profile between those with or without ADHD.

Tools of psychological examination help with the assessment of the emotional state of patients with epilepsy

2021 ◽  
pp. 107932
Author(s):  
Magdalena Gugała-Iwaniuk ◽  
Ksenia Sławińska ◽  
Anna Bochyńska ◽  
Magdalena Konopko ◽  
Rafał Rola ◽  
...  
Keyword(s):  
Emotional State ◽  
Psychological Examination ◽  
Patients With Epilepsy

scholarly journals Neuropsychological assessment in epilepsy

2018 ◽  
Vol 18 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Sallie Baxendale
Keyword(s):  
Patient Group ◽  
Neuropsychological Assessment ◽  
Test Scores ◽  
Neuropsychological Test ◽  
Optimal Timing ◽  
The Past ◽  
Patients With Epilepsy

The role of the neuropsychological assessment in the management of people with epilepsy has evolved considerably over the past 25 years. This paper describes some of the most common applications of a neuropsychological assessment in the diagnosis, management and treatment of people with epilepsy. It describes the factors that influence the interpretation of neuropsychological test scores in this patient group and outlines the limitations of the investigation. It gives guidelines for the optimal timing of a referral, together with timelines and indications for reassessment, and provides a checklist to help the referring clinician get the most from a neuropsychological assessment for their patients with epilepsy.

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