Write a discussion paper on Neurological Basis of Behavior, psychopathology
§ CASE STUDY = MAXIMUM 750-800 WORDS o ~ 2.5-3.0 DOUBLE-SPACED PAGES
o 2.5 CM MARGINS, TIMES NEW ROMAN, 12 POINT FONT
Complete the case analysis by addressing each of the following points (i-iv) below.
(i) Identify the signs and symptoms
(ii) Suggest possible brain region(s) that might be implicated
(iii) Recommend additional tests/assessments or other sources of information that might
help you to narrow your diagnosis options.
(iv) Identify a possible etiology (e.g., brain injury, stroke, neurodegenerative disease etc. –
justifying your choice of course!)
History/Demographics
The patient was a 72-year-old right-handed retired bank manager who was first referred for evaluation of progressive memory and word finding difficulties. Neurological examination was normal except for the cognitive deficits described below.
1st Assessment: July 2016
When he was first assessed for general intelligence his verbal and performance IQs were average. However, in view of his educational and occupational record these figures were clearly below his estimated high average/superior premorbid optimal level of functioning. He obtained a very poor score on a test of picture naming. His memory score on the Wechsler Memory Scale (a test battery to assess new memory formation) was below average. He had word finding difficulties, which were underpinned by word and picture comprehension impairments. His visual perceptual functions were within the normal range. Similarly, performance was normal on two tasks of frontal executive dysfunction.
2nd Assessment: January 2019
By his second assessment, the most notable features were increasingly severe language difficulties, progressive decline of his memory (which was now in the impaired range on standardized testing) and emotional changes. In a picture description task, he produced fluent, normally articulated, grammatically correct but factually empty speech punctuated with frequent word finding difficulties (Cookie test scene from the Boston Diagnostic Aphasia Examination – note we saw this test on video in the Aphasia class). Formal reassessment of his naming skills revealed that he was almost unable to orally name any items from the picture naming test, either producing paraphasias or “don’t know” answers. His performance on tests of visual spatial ability was now below average. His scores on two tests sensitive to frontal lobe dysfunction had dropped into the mildly impaired range and his wife was reported that he was very anxious and became agitated more easily.
