一名讲西班牙语的青少年耐药性癫痫患者的非典型语言组织:一份多元文化病例报告。

IF 3 3区 心理学 Q2 CLINICAL NEUROLOGY Clinical Neuropsychologist Pub Date : 2024-09-30 DOI:10.1080/13854046.2024.2405086
Jenna A Chiang, Laura K Winstone-Weide, Dave F Clarke, Rosario C DeLeon
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引用次数: 0

摘要

目的:癫痫对西班牙裔/拉丁美洲裔儿童的影响尤为严重,尤其是那些在美国境外出生的儿童。与种族(如语言使用)相关的长期健康相关差异进一步加剧了护理方面的差距。神经心理学家已开始概述与非英语人士合作时的最佳实践;然而,手术前语言评估缺乏适当的规范/验证措施是一个限制因素。本报告通过使用多元文化框架和合作治疗评估流程讨论非英语使用者的非典型语言组织,为神经心理学家的实践提供参考。方法:本研究介绍了一名 16 岁、右撇子、单语西班牙语的拉丁裔女性患者,她患有耐药性局灶性癫痫发作且意识受损。手术前的全面癫痫检查包括全血细胞计数、视频脑电图、脑核磁共振成像、功能性核磁共振成像、正电子发射计算机断层扫描、MEG、由西班牙语和英语双语医疗人员进行的基线神经心理评估以及 Wada 测试。结果:神经心理学测试表明,患者在语言、工作记忆和处理速度方面存在最明显的缺陷。功能磁共振成像显示双侧语言激活,Wada 测试证实了这一点以及双侧记忆表征。结论本文讨论了诊断、治疗、手术干预和术后状况。从多元文化的视角审视了临床过程,强调了国际医疗服务的局限性、在美国获得医疗服务的障碍以及临床决策过程中考虑的患者特定因素。此外,还提供了与文化知情护理相关的针对性建议。
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Atypical language organization in a Spanish-speaking adolescent with drug-resistant epilepsy: a multicultural case report.

Objective: Epilepsy disproportionally affects children from Hispanic/Latino backgrounds, particularly among those born outside the U.S. Longstanding health-related disparities associated with ethnicity (e.g. language use) further contribute to gaps in care. Neuropsychologists are beginning to outline best practices when working with non-English speakers; however, the lack of appropriately normed/validated measures for pre-surgical language evaluation is a limiting factor. This report informs practices among neuropsychologists by discussing atypical language organization in a non-English speaker using a multicultural framework and collaborative therapeutic assessment process. Method: The current study presents a 16-year-old, right-handed, monolingual Spanish-speaking, Latina designated female with drug-resistant focal seizures with impaired awareness. Comprehensive presurgical epilepsy workup included: CBC, video EEG, brain MRI, functional MRI, PET, MEG, baseline neuropsychological evaluation by bilingual Spanish-English providers, and Wada testing. Results: Neuropsychological testing revealed the most pronounced deficits in language, working memory, and processing speed domains. Functional MRI showed bilateral language activation, which Wada testing confirmed along with bilateral memory representation. Conclusion: Diagnosis, treatment, surgical intervention, and post-operative status are discussed. The clinical course is examined through a multicultural lens, highlighting limitations in international health services, barriers accessing health care in the U.S., and patient-specific factors that were considered as a part of the clinical decision-making process. Targeted recommendations related to culturally-informed care are offered.

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来源期刊
Clinical Neuropsychologist
Clinical Neuropsychologist 医学-临床神经学
CiteScore
8.40
自引率
12.80%
发文量
61
审稿时长
6-12 weeks
期刊介绍: The Clinical Neuropsychologist (TCN) serves as the premier forum for (1) state-of-the-art clinically-relevant scientific research, (2) in-depth professional discussions of matters germane to evidence-based practice, and (3) clinical case studies in neuropsychology. Of particular interest are papers that can make definitive statements about a given topic (thereby having implications for the standards of clinical practice) and those with the potential to expand today’s clinical frontiers. Research on all age groups, and on both clinical and normal populations, is considered.
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