Dr Judith Guedalia

Standardized neuropsychological test batteries demonstrate their greatest reliability and validity in patients with focal, well-defined neurologic disease. In these patients, the test profiles typically highlight focal areas of strengths and weaknesses in the brain. However, the clinical utility of standard test batteries and their reliance on scaled score differences is limited when evaluating patients with severe or diffuse neurobehavioral disorders. In the present case study, we applied the qualitative approach of Alexander Luria to the neuropsychological evaluation of a severely impaired adolescent, unable to complete psychometric tests. Luria's investigative method was able to assist in the localization of the brain dysfunction and the neurologic diagnosis of a young patient with an unusual neurologic presentation secondary to serious multisystem disease. The initial neuropsychological diagnostic impressions were later confirmed by diagnostic testing. The test results were also used to provide recommendations for ongoing neurorehabilitation of the patient.

Article Outline

• Introduction

• Medical history

• Neurodiagnostic test findings

• Neuropsychological evaluation

• Assessment of the “Individual Analyzers” (e.g., Sensory Evaluation)

• Investigation of Motor Functions

• Investigation of the Higher Visual Functions

• Investigation of Mnestic Processes

• Investigation of Speech Functions-Receptive Speech

• Investigation of Speech Functions-Expressive Speech

• Investigation of Writing and Reading

• Investigation of Arithmetical Skill

• Investigation of Intellectual Process

• Follow-up

• Discussion

• Acknowledgements

• References

 

Judith Guedalia, Yoram Finkelstein, Alfred Drukker and Yaacov Frishberg

Guedalia, J., Finkelstein, Y., Drukker, A.., and Frischberg, Y.;  The use of Luria’s method for the neurobehavioral assessment of encephalopathy in an adolescent (Application in a rehabilitation setting.) Archives of Neuropsychology, 15:2(pp.177-184), 2000.