LeMonda Brittany C, Peck Caleb P, Giles Katherine J, Bowers Dawn
a Department of Clinical and Health Psychology , University of Florida , Gainesville , FL , USA.
b Comprehensive Epilepsy Center , New York University Langone Medical Center , New York , NY , USA *
Clin Neuropsychol. 2015;29(5):689-706. doi: 10.1080/13854046.2015.1076891.
Susac's syndrome is a rare autoimmune disease characterized by encephalopathy, retinal artery occlusions, hearing loss, and lesions to the corpus callosum. To date, only four papers (five cases) have described the neuropsychological effects of the syndrome. Extant case reports of Susac's syndrome have documented varying levels of cognitive impairment; some studies have identified diffuse cerebral dysfunction, while others describe more focal impairments in attention, memory, and executive functioning.
The goal of this case study was to provide comprehensive neurocognitive data obtained from another case of confirmed Susac's syndrome. As such, we present the case of a 42-year-old woman with a two-year history of Susac's syndrome. At the time of the neuropsychological evaluation, the patient described ongoing difficulties with memory, word-finding problems, problems with math, and poor problem-solving. Physical/sensory changes included hearing loss, tinnitus, and migraines.
Neuropsychological test results revealed the patient to be a woman of estimated average to high average premorbid intellect who exhibited a number of focal inefficiencies in the context of a generally intact profile. Particular cognitive weaknesses emerged on select tasks involving visuoconstruction, encoding of a wordlist, and bilateral speeded finger oscillations. She also committed three failures to maintain set on a task of cognitive flexibility. There was no evidence of memory deficits.
Our findings provide further evidence of cognitive interindividual variability in a confirmed case of Susac's syndrome.
Susac综合征是一种罕见的自身免疫性疾病,其特征为脑病、视网膜动脉阻塞、听力丧失和胼胝体病变。迄今为止,仅有四篇论文(五例)描述了该综合征的神经心理学影响。Susac综合征的现有病例报告记录了不同程度的认知障碍;一些研究发现存在弥漫性脑功能障碍,而另一些研究则描述了在注意力、记忆力和执行功能方面更具局灶性的损伤。
本病例研究的目的是提供从另一例确诊的Susac综合征病例中获得的全面神经认知数据。因此,我们报告一名42岁女性,她有两年的Susac综合征病史。在进行神经心理学评估时,患者称在记忆、找词、数学运算和解决问题方面持续存在困难。身体/感觉方面的变化包括听力丧失、耳鸣和偏头痛。
神经心理学测试结果显示,该患者病前智力估计处于平均水平至较高平均水平,在整体情况基本正常的背景下表现出一些局灶性低效。在涉及视觉构建、单词表编码和双侧快速手指摆动的特定任务中出现了明显的认知弱点。她在一项认知灵活性任务中还出现了三次无法维持任务定势的情况。没有记忆缺陷的证据。
我们的研究结果为确诊的Susac综合征病例中的认知个体差异提供了进一步证据。