Non-credible language deficits following mild traumatic brain injury.
Clin Neuropsychol
; 24(6): 1006-25, 2010 Aug.
Article
em En
| MEDLINE
| ID: mdl-20614387
ABSTRACT
Identification of non-credible memory and other cognitive symptoms has received widespread attention within the past two decades. However, minimal information is available regarding patterns of non-credible language symptoms. We present the case of a 36-year-old female civil litigant who displayed delayed onset, severe, relatively focal speech and language symptoms, including difficulties with articulation, dysfluent speech, expressive language impairments with minor receptive difficulties, and lack of prosody, subsequent to a minor head trauma. On neuropsychological evaluation 3 years post injury, the patient presented with the same speech/language characteristics, but additionally exhibited a vague "foreign accent." Cognitive scores generally were normal with the exception of poor performance on many language tasks and processing/motor speed. The patient showed passing performance on most measures of response bias, but she failed effort indicators requiring rapid letter discrimination (b Test), rapid verbal repetition (timed forward digit span), and sensory function (finger agnosia errors) while passing effort indicators falling within the domains of memory, math/number skills, visuo-constructional ability, and attention. Thus, the type of failed effort indicators predicted the categories of standard cognitive tests on which she underperformed. Personality testing revealed patterns generally consistent with hysterical personality orientation. Given her long-standing history of multiple unexplained medical symptoms, the patient was diagnosed with a somatization disorder, as well as a current conversion disorder involving language symptoms. However, given her compensation-seeking status, the possibility of additional conscious feigning of symptoms could not be ruled out. The need for validation of additional measures to detect feigned language impairment is recommended.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Lesões Encefálicas
/
Transtornos da Linguagem
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
Limite:
Adult
/
Female
/
Humans
Idioma:
En
Revista:
Clin Neuropsychol
Assunto da revista:
NEUROLOGIA
/
PSICOLOGIA
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Estados Unidos
País de publicação:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
/
UK
/
UNITED KINGDOM