Acosta M T
Rev Neurol. 2000;31(4):360-7.
This review presents the maturational model of the right hemisphere syndrome in children, its clinical manifestations and its relationship with non-verbal learning disabilities.
The white matter model proposed by Rourke is presented and the clinical symptoms that are generally associated with right hemisphere dysfunction, independent of which hemisphere is affected, are highlighted. It has been proposed that the right hemisphere have proportionally more white matter than the left hemisphere which implies different adaptation processes for each one after brain lesions. There are different factors that determine these results: brain plasticity acts in different ways in each hemisphere; early brain injuries, affect specially right hemispheric functioning in its abilities to be in charge of new material processing and building new schemes that are also used by the left hemisphere. Some pathologies that are related with the clinical manifestations of non-verbal learning disabilities are presented. According with this model, they display basic neuropsychological features, even though their clinical manifestations could change between them. The Attention Deficit Hyperactivity disorder is specially considered as the most recent evidence of right hemispheric dysfunction, although results in this pathology are controversial, from the neuropsychological point of view. In general, the right hemisphere lesion in children has different implications when it is compared with adult's lesions. The white matter model could explain different processes in the plasticity brain mechanism. Preservation of basic language aspects is observed, but a deficit in non-verbal abilities that interferes with normal functioning is a rule. A specific clinical profile of assets and deficits is presented in most of the cases. These characteristics should be considered in treatment implementations.
本综述介绍了儿童右脑综合征的成熟模型、其临床表现及其与非言语学习障碍的关系。
介绍了Rourke提出的白质模型,并强调了通常与右脑功能障碍相关的临床症状,而不考虑受影响的是哪个半球。有人提出,右脑的白质比左半球相对更多,这意味着脑损伤后每个半球的适应过程不同。有不同的因素决定这些结果:大脑可塑性在每个半球以不同方式起作用;早期脑损伤特别影响右脑在负责新材料处理和构建新方案方面的功能,而左半球也会使用这些方案。文中介绍了一些与非言语学习障碍临床表现相关的病症。根据该模型,它们表现出基本的神经心理学特征,尽管它们的临床表现可能各不相同。注意力缺陷多动障碍被特别视为右脑功能障碍的最新证据,尽管从神经心理学角度来看,该病症的结果存在争议。一般来说,儿童右脑损伤与成人损伤相比有不同的影响。白质模型可以解释可塑性脑机制中的不同过程。观察到基本语言方面得以保留,但非言语能力缺陷干扰正常功能是常见现象。大多数情况下会呈现出特定的优势和缺陷临床概况。在治疗实施过程中应考虑这些特征。