Lee G P, Hamsher K D
University of Wisconsin Medical School.
J Clin Exp Neuropsychol. 1988 Dec;10(6):769-78. doi: 10.1080/01688638808402813.
Patients with acute confusional states display impaired attention and memory with difficulty following complex verbal commands. In addition to these deficits, we have observed a selective impairment in spatial thinking similar to that present following right-hemisphere lesions. Consequently, we compared patients with acute confusional states (CS) to patients with focal right-hemisphere disease (RHD) and controls on a standard neuropsychological battery. Although impaired relative to controls, both CS and RHD groups did not differ from each other on those tests typically associated with right-hemisphere lesions. These included performance IQ, constructional praxis, spatial judgment, and cancellation tasks. In light of these findings, the neurological correlates of selective deficits in spatial processes include not only unilateral right-hemisphere lesions, but also diffuse disorders such as CS. Thus, there is the potential to misinterpret the neuropsychological test results of patients with diffuse cerebral disorders as indicating focal abnormalities when none exist.
处于急性意识模糊状态的患者表现出注意力和记忆力受损，难以听从复杂的言语指令。除了这些缺陷外，我们还观察到他们在空间思维方面存在选择性损伤，类似于右侧半球病变后的表现。因此，我们使用标准的神经心理测验组，将急性意识模糊状态（CS）患者与右侧半球局灶性疾病（RHD）患者及对照组进行了比较。尽管相对于对照组而言，CS组和RHD组均受损，但在那些通常与右侧半球病变相关的测试中，两组之间并无差异。这些测试包括操作智商、结构性实践、空间判断和划消任务。鉴于这些发现，空间处理选择性缺陷的神经学关联不仅包括单侧右侧半球病变，还包括诸如CS等弥漫性疾病。因此，当不存在局灶性异常时，有可能将弥漫性脑疾病患者的神经心理测试结果错误地解释为表明存在局灶性异常。
