Rare Conditions, Diagnostic Challenges, and Controversies in Clinical Neuropsychology

This book highlights those rare, difficult to diagnose or controversial cases in contemporary clinical neuropsychology. The evidence base relevant to this type of work is almost by definition insufficient to guide practice, but most clinicians will encounter such cases at some point in their careers. By documenting the experiences and learning of clinicians who have worked with cases that are 'out of the ordinary', the book addresses an important gap in the literature. The book discusses 23 challenging and fascinating cases that fall outside what can be considered routine practice. Divided into three sections, the text begins by addressing rare and unusual conditions, defined as either conditions with a low incidence, or cases with an atypical presentation of a condition. It goes on to examine circumstances where an accurate diagnosis and/or coherent case formulation has been difficult to reach. The final section addresses controversial conditions in neuropsychology, including those where there is ongoing scientific debate, disagreement between important stakeholders, or an associated high-stakes decision. This text covers practice across lifespan and offers crucial information on specific conditions as well as implications for practice in rare disorders. This book will be beneficial for clinical neuropsychologists and applied psychologists working with people with complex neurological conditions, along with individuals from medical, nursing, allied health and social work backgrounds. It will further be of appeal to educators, researchers and students of these professions and disciplines.

Dr. Jessica Fish is a clinical psychologist and neuropsychologist. Trained at the universities of Exeter, Cambridge, and King's College London, she is a lecturer and researcher at the University of Glasgow, and works clinically at St George's Hospital, London. Her primary expertise is in acquired brain injury and neuropsychological rehabilitation. Dr. Shai Betteridge is Consultant Clinical Neuropsychologist and Chief Psychological Professions Officer at St George's University Hospitals NHS Foundation Trust, and a founder and director of Allied Neuro Therapy Ltd. Her fields of expertise include neuropsychological rehabilitation, service development, quality improvement and clinical excellence, spanning both public and private sectors. Dr. Barbara Wilson is a world-renowned clinical neuropsychologist. Now retired, Barbara has developed 8 neuropsychological tests, written 32 books, and published more than 300 papers and chapters. Her main contributions are in ecologically valid assessment approaches, cognitive rehabilitation and errorless learning, the holistic model of rehabilitation, and disorders of consciousness.

1. Introduction: Rare Disorders, Diagnostic Conundrums, and Controversies in Clinical Neuropsychology. Section 1. Rare conditions. 2. Gas Geyser Syndrome in India: A Tragic, Preventable Neuropsychological Morbidity. 3. Disconnection syndrome and optic aphasia following left hemisphere posterior cerebral artery stroke: A deductive assessment approach. 4. Creutzfeldt-Jakob Disease presenting with Capgras Syndrome. 5. A rare and challenging differential diagnosis: Prosopagnosia and reduced empathy in right-variant semantic dementia - where "understanding does not map onto reality". 6. A life in Portrait mode: Living with Balint's Syndrome. 7. Exploring the unknown: Shared discovery in rare mitochondrial disease. 8. Galactosaemia: A rare metabolic disorder associated with 'hidden' deficits and social vulnerability. 9. Anti N-methyl-D-aspartate receptor antibody encephalitis: post-acute neuropsychological consequences and rehabilitation in adolescence. Section 2. Diagnostic Challenges. 10. Neuropsychological, Neuropsychiatric and Functional Neurological Symptoms: The Challenges of Overlapping and Evolving Presentations. 11. Factitious Disorder after severe head injury. 12. Deafness or brain injury? Diagnostic overshadowing in a deaf person with bilateral temporal lobe damage and visual agnosia. 13. Aerotoxic Syndrome: Are passengers and aircrew breathing toxic cabin air? 14. Focal Anterograde Amnesia: An Extraordinary Case. 15. "Ugly sound": An examination of acquired receptive amusia in a skilled music critic. 16. Variability & Validity: Challenges to Meaningful Neuropsychological Assessment in Mental Health Settings. 17. Recognising Autism Spectrum Disorder in Adult Neuropsychology Services. 18. What's in the diagnosis of 'ASD' in the context of Paediatric ABI? Section 3. Controversial issues. 19. The dilemmas surrounding the decision to reject or accept a postgraduate research student with known cognitive difficulties and a history of an arteriovenous malformation several years prior. 20. Mild Traumatic Brain Injury: Diagnostic Difficulties and Legal Controversies. 21. Does this man have or not have mental capacity to make decisions about his discharge from hospital? 22. The importance of accuracy when diagnosing Locked-in-syndrome (LIS). 23. Ethical and practical issues for the psychologist working with patients with a disorder of consciousness. 24. Losing memories overnight: A unique form of human amnesia or life imitating art? Conclusion. 25. Learning from Experience: How can we best help people with rare, difficult to diagnose, or controversial conditions?