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man who writes on x-rays

Alice's neuropsychological document

Presentation of Alice’s neuropsychological data.

This is the second part of Alice’s comprehensive neuropsychological report which will be presented in the third week (Step 3.7). As was the case with the medical history, it is useful to read this article to match a real assessment with the theoretical knowledge on neuropsychological evaluation explained throughout the week.

Referral question: Alice needs to begin a new cognitive rehabilitation programme.

Cognitive history:

In 2017 Alice was assessed with two neuropsychological evaluations, showing deficits in language, memory and executive functions. Some difficulties were also found in social cognition. One year after hospitalization, she obtained her high school diploma and she was able to study English and French again. However, she found difficulties in picking up German again. Two years after hospitalization, Alice did a three-month cognitive rehabilitation programme with speech therapy because of persevering cognitive deficits. The improvement following the treatment increased Alice’s autonomy and her awareness of the disorder. Nevertheless, some executive, attentive and working memory deficits are still present. Alice still has problems in planning her speech and finding the right words.

Neuropsychological interview:

Alice shows good introspection and is motivated to begin a new cognitive rehabilitation, especially because she would like to improve her speech. Her language is fluent and correct, the content is adequate, but she presents anomias and circumlocutions. Furthermore, she sometimes uses passe-partout words. These deficits affect her abstract thinking. Nevertheless, overall language comprehension and production is preserved. For example, Alice is able to describe her future plans.

Neuropsychological and psychometric examination:

After the interview, Alice does the version B of the MoCA test (Montreal Cognitive Assessment). The results are average but some executive difficulties (e.g., perseveration) actually emerge. She is not certain about how to organize mental images and she is easily distracted. She shows some difficulties in arithmetic calculations and fails the clock test. All these difficulties associated with the need to have instructions repeated reflect a general deficit in working memory (updating and managing information).

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Understanding Epilepsy and its Neuropsychology

University of Padova

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