Qualitative block design performance in epilepsy patients.

Broken configuration errors on the WAIS-R Block Design subtest have been associated with right hemisphere brain damage. This study examined whether pre-surgical epilepsy patients with seizure foci restricted to the right hemisphere would break configuration more frequently than those with left hemisphere foci. Subjects included 38 patients with unilateral right or left hemisphere epilepsy of frontal or temporal lobe origin. The left and right hemisphere groups did not differ significantly in demographic or disease variables, IQ, or Block Design standard scores. Right hemisphere patients made more broken configurations than did those with left hemisphere foci. In the right hemisphere group, more broken configurations were associated with a lower Block Design Scaled Score and Full Scale IQ. These results suggest that the observation of broken configurations in the Block Design can assist in corroborating the seizure focus and highlight the importance of qualitative Block Design analysis.

Neurobehavioral Cognitive Status Examination: its use with unilateral stroke patients in a rehabilitation setting.

The Neurobehavioral Cognitive Status Examination (NCSE) was administered to 12 patients with right unilateral stroke and 12 with left unilateral stroke and to 12 orthopedic, non-brain-dysfunctional patients who were matched in age and education, for the purpose of studying its usefulness in characterizing cognitive deficits in a stroke rehabilitation population. MANOVA demonstrated significant differences (Phillai's trace, p = .007) between the stroke groups and the controls, but not between the unilateral stroke groups. Significant univariate Fs (F[2,3], p less than .05) occurred between the stroke groups and the controls in comprehension, naming, constructions, memory, and similarities. Correlations revealed strong relationships among the scales; little relationship to age was found. Education correlated with attention, comprehension, repetition, and similarities. The number of medications patients were taking did not correlate with either individual scale scores or an overall score on the NCSE. The test was found to be sensitive to cognitive effects of stroke, although there was little discrimination between left-sided and right-sided strokes. The correlational structure of the test's scales provided general support for an attention/concentration dimension, at least one general language dimension, and a general memory dimension. Further factor analytic study was recommended to more definitively assess the test's factorial dimensions. Individual descriptive data suggested that the screen and the last item of the constructions scale were too difficult. It was suggested that the item be changed or that a clue be offered to the patient.