Miranda Michelle, Arias Franchesca, Arain Amir, Newman Blake, Rolston John, Richards Sindhu, Peters Angela, Pick Lawrence H
University of Utah, Department of Neurology, Salt Lake City, UT 84132, USA.
Hinda & Arthur Marcus Institute for Aging Research at the Hebrew SeniorLife, Boston, MA 02131, USA.
Epilepsy Behav Rep. 2022 Jun 22;19:100558. doi: 10.1016/j.ebr.2022.100558. eCollection 2022.
In high-stake cases (e.g., evaluating surgical candidacy for epilepsy) where neuropsychological evaluation is essential to care, it is important to have culturally and linguistically appropriate and accessible neuropsychological instruments and procedures for use with deaf individuals who use American Sign Language (ASL). Faced with these ethical and professional issues, clinicians may be unable to provide equitable services without consulting with other psychologists and collaborating with the patient and interpreter. This is a case report describing a 43-year-old male with bilateral sensorineural deafness and a lifelong history of drug-resistant temporal lobe epilepsy who presented as a candidate for a comprehensive neurological workup to determine surgical candidacy. He was bilingual (ASL and written English). We describe all aspects of the evaluation, including functional magnetic resonance imaging (fMRI) and Wada testing, using an ASL interpreter. Results from the neuropsychological evaluation were not clearly lateralizing, but suggested greater compromise to the non-dominant right hemisphere. fMRI and Wada test results revealed language and verbal memory functions were lateralized to the left hemisphere. The patient was deemed to be an adequate candidate for surgical resection of portions of the right hemisphere. Comprehensive assessment of neuropsychological functioning in deaf persons who use ASL is feasible. This case report illustrates the important considerations relevant to neuropsychologists providing culturally and linguistically informed assessments to deaf ASL users with epilepsy. Additional research in this area will support future efforts to develop effective and efficient models that could be implemented across different settings. Moreover, clinical guidance is warranted to guide professionals interested in promoting access to high quality neuropsychological services.
在高风险病例中（例如，评估癫痫的手术候选资格），神经心理学评估对治疗至关重要，因此拥有文化和语言上合适且易于获取的神经心理学工具和程序，供使用美国手语（ASL）的聋人使用非常重要。面对这些伦理和专业问题，临床医生若不咨询其他心理学家并与患者及口译员合作，可能无法提供公平的服务。这是一份病例报告，描述了一名43岁的男性，患有双侧感音神经性耳聋，有耐药性颞叶癫痫的终生病史，前来接受全面的神经学检查以确定手术候选资格。他会双语（ASL和书面英语）。我们描述了评估的各个方面，包括使用ASL口译员进行的功能磁共振成像（fMRI）和Wada测试。神经心理学评估结果并未明确显示出偏向性，但表明非优势右半球受到的损害更大。fMRI和Wada测试结果显示语言和言语记忆功能定位于左半球。该患者被认为是右半球部分切除术的合适候选者。对使用ASL的聋人的神经心理功能进行全面评估是可行的。这份病例报告说明了神经心理学家在为患有癫痫的ASL聋人提供具有文化和语言针对性的评估时应考虑的重要因素。该领域的更多研究将支持未来开发可在不同环境中实施的有效且高效模型的努力。此外，需要临床指导来指导那些希望促进高质量神经心理学服务获取的专业人员。
