Abstract:
Objective: We report a neuropsychological evaluation for a 39-year-old, right-handed, white female who 8 years ago developed delayed post-hypoxic leukoencephalopathy (DPHL), a rare demyelinating syndrome, two-weeks following an anoxic brain injury due to an overdose from benzodiazepines. Methods: An extensive record review documenting her medical timeline and treatment over the last 8 years was conducted using the available EMR system, which also included both EEG and neuroimaging data. Eight years post injury, a comprehensive neuropsychological battery was administered with corrected normative data for age, race, education, and other demographic factors when available. Collected data was compared with other case reports of DPHL. Results: The neuropsychological profile indicated difficulties across multiple cognitive domains that appeared driven by executive dysfunction, likely related to fronto-subcorto-striatal dysfunction. Conclusion: As a rare disease, the process by which DPHL occurs is not fully understood. Our results revealed similar findings in the literature for learning and memory, attention, processing speed, and executive functions. This is discussed in the context of available neuroimaging while highlighting the value of comprehensive neuropsychological assessment in DPHL even years post-injury.
摘要:
目标:我们报告了一个39岁的神经心理学评估,右撇子,8年前出现迟发性缺氧后白质脑病(DPHL)的白人女性,一种罕见的脱髓鞘综合征,由于苯二氮卓类药物过量而导致缺氧脑损伤两周后。方法:使用可用的EMR系统进行了广泛的记录审查,记录了她过去8年的医疗时间表和治疗情况。其中还包括EEG和神经影像学数据。受伤8年后,一个全面的神经心理学电池使用校正的年龄规范数据进行管理,种族,教育,和其他可用的人口因素。将收集的数据与DPHL的其他病例报告进行比较。结果:神经心理学概况表明,由执行功能障碍引起的多个认知领域的困难,可能与额骨下纹状体功能障碍有关。结论:作为一种罕见疾病,DPHL发生的过程尚不完全清楚。我们的结果在学习和记忆的文献中揭示了类似的发现,注意,处理速度,和执行功能。在可用的神经影像学背景下对此进行了讨论,同时强调了DPHL受伤后甚至数年的综合神经心理学评估的价值。