EVALUATION AND NEUROPSYCHOLOGICAL REHABILITATION IN HERPETIC ENCEPHALITIS

MICHELLE KEIKO AKATSUKA WALEVEIN

Resumo


In June 2012, the patient N.C.S was referred by a neurologist because of neuropsychological sequelae (anterograde and retrograde amnesia) of herpetic encephalitis treated on 15/06/2012, which is also the main complaint of the family. During the evaluation, was using Quetiapine 200mg, Gabapentin 400mg and 500mg Torval CR.

Before the episode, working as a cashier in a store building materials. During the evaluation, the patient was independent in basic ADLs, but needed assistance with the instrumental. .

By analyzing the results of neuropsychological assessment showed that the efficiency intelligent well below the expected result for age and education. Damage was detected in attentional process , executive functioning and memory . The attentional process are affected , ranging in moderate to severe in all activities . Severe difficulty in activities that assessed mental manipulation, as well as sequencing and logical reasoning and fluid. There was distress in all memory process and all activities involving language. The patient showed difficulty in relation to issues visuospatial because their performance in activities involving visual perception and simultaneous processing was impaired.

After the evaluation, we began the process of neuropsychological rehabilitation, whose main goal was to make her resume some activities always seeking their independence and life quality through techniques involving:

•             Orientation to reality

•             Therapy reminiscent

•             Compensatory strategies/ external aid ( early stage)

•             Cognitive training/ role play (memory usage implicit or procedural)

•             Learning without errors

•             Orientation to family

There was improvement in the temporal-spatial orientation and especially independence in basic and instrumental ADLs , because it no longer needs assistance in managing their medications and personal care and the home. The patient has shown more self -confident and independent in various situations.


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