Cognitive functioning in patients with spina bifida, hydrocephalus, and the “cocktail party” syndrome

Abstract

The cocktail party syndrome is a disorder seen in some patients with a history of hydrocephalus and it is particularly prevalent among patients with spina bifida. Patients with the disorder are verbose with good articulation, but are noted to have shallow intellect, poor social skills, poor academic skills, and poor daily living skills. Previous research has reported a close association between low IQ and the syndrome, with most patients having a higher Verbal than Performance IQ. Because many individuals with low IQ display similar characteristics, however, IQ itself may be a confounding variable. Further, many patients with spina bifida and hydrocephalus have low IQ or a Verbal‐Performance difference but do not have the cocktail party syndrome. Thus, the purpose of our study was to determine the relationships among spina bifida and hydrocephalus, the cocktail party syndrome, and cognitive measures of intelligence, reasoning ability, academic achievement, social achievement, and deeper comprehension of language. Fifty children and young adults with spina bifida and hydrocephalus were assessed on a battery of cognitive tests. Independent raters judged 15 subjects to have the cocktail party syndrome, 25 to be normal functioning, and 15 subjects not to have the cocktail party syndrome but to be dysfunctional in many significant areas. The results showed that all subjects showed a significant impairment in cognitive functioning. The cocktail party subjects were characterized by having poor abstract reasoning skills, poor visual perceptual skills, low IQ, and poor academic skills. There was no particular pattern associated with the cocktail party syndrome that differentiated those subjects from the low IQ subjects other than poor academic achievement. The dysfunctional subjects had preserved verbal skills and poor visual perceptual skills. Recommendations for education and rehabilitation plans are made and possible hypotheses regarding brain‐behavior relationships are suggested.