NEUROPSYCHOLOGICAL ASSESSMENT
A CASE OF POSTERIOR CORTICAL ATROPHY
Svetlana Iloski1, Katerina Karanfilovik1, Gabriela Novotni1,2, Tina Vaskov3,
1University Clinic of Neurology, Skopje, Macedonia
2Faculty of Medicine, University Cyril and Methodius, Skopje, Macedonia
3Cognition Center for Neuropsychology, Psychotherapy and Psychology, Skopje, Macedonia
Introduction
NEUROCOGNITIVE PROFILE
Results
Date: 04.09.2018
• Neurodegeneration of posterior brain area (occipitoparietal and / or temporal).
• Onset before age 65 years.
• Gradual progression
• Prominent early visual disturbances.
ACE-R 52/100
Attention and orientation
(10/18)
Memory
(15/26)
Fluency
(5/14)
Language
(18/26)
Visuospatial abilities
(4/16)
Method: Neurocognitive assessment
Interview, ACE-R, WB II, RAVLT, ROCF, WSCT, BNT, BDAE,
TMT, STROOP, HVOT.
Cognitive assessments ware made on : 04.09.2018.
27.03.2019.
MMSE 19/30
CTD
1/5
Date: 27.03.2019
Case KM
ACE-R 37/100
Attention and orientation
(9/18)
Memory
• from Skopje, at 51 y., 16 y. of education,
• retired teacher, widow, mother of one child,
• native language Macedonian, right-handed.
Medical history:
• from early childhood she is treated under dg. Epilepsy
(there have been frequent attacks this summer).
• 1 and a half years ago she had a strong emotional
stressful event. Immediately afterwards, unusual
changes have been recorded:
• she wanted to go to work before dawn, or she would go
to work with a different pair of shoes.
• she couldn’t respond to professional demands (difficulty
with calculating and writing)
RAVLT
Learning curve 5-6-7-8-7
Retention 2
Evocation 3
List B1 1
Fluency
MMSE 18/30
CTD
1/5
(9/26)
(3/14)
Language
(15/26)
Visuospatial abilities
(1/16)
RAVLT
Learning curve 2-4-5-4-5
Retention 2
Evocation 0
list B1 2
perseverations 5
confabulations 5
perseverations of confabulations 8
Current condition:
• doesn’t use household appliances.
• doesn’t recognize people (other than close ones).
• doesn’t write (mixing numbers and letters), reads with
effort, constantly " rummages" something.
• needs help in dressing.
• she is withdrawn, often in bad mood, she doesn’t speak
much.
•
she lives with primary family, because she needs help
and custody.
Medical exams confirm hypoperfusion in parietal lobes (a
finding in addition to AD).
Conclusion
Early symptoms
• blurred vision and increased sensitivity to light or shiny
surfaces,
• double images,
• difficulties with perception of depth,
• distinguishing moving objects,
• inability to perceive more than one object at the same time,
• disorientation.
Discussion
• The diagnosis remains problematic, often early detection is
delayed, as patients initially appear at the ophthalmologists.
• Our goal is to increase awareness of this issue and to improve
the discovery of early and unusual symptoms of Posterior
Cortical Atrophy.
• To provide education for patients, care givers and health
workers.
The results of neuropsychological testing show global, diffuse
cognitive deterioration. Spatial cognition, executive abilities and
memory are predominantly affected, and they are accompanied
by marked declination of attention and concentration, in praxis
and language difficulties. Changes in the cognitive sphere are
followed by changes in personality. The described deterioration
can be explained by the diagnosis Posterior Cortical Atrophy.