H - 24 The Role of Bilingual Neuropsychologists in Presurgical Epilepsy Evaluations: La Evaluación Comprensiva en Español.

Abstract

As neuropsychologists continually work to establish clinical standards of practice for evaluation of linguistically and culturally diverse children with epilepsy (Berrios-Siervo et al., 2023), this case study supports efforts to document complex assessment procedures with an adolescent who recently immigrated from Mexico to the U.S. A 16-year-old, right-handed, primarily Spanish-speaking, Hispanic male with intractable epilepsy (complex partial seizures) was referred for a presurgical neuropsychological evaluation. Medication was initiated in Mexico at age 11years, but increased frequency and severity of seizures prompted immigration to the U.S. at age 14 for further treatment. EEG and brain MRI indicated left hemisphere involvement. Magnetoencephalography results indicated right-hemisphere dominance for receptive language. Functional MRI (fMRI) indicated left-hemisphere dominance. Subsequent Wada and bilateral language mapping results supported left-hemisphere dominance. Personal history was significant for anxiety and depressed mood. Bilingual neuropsychologists completed a presurgical evaluation, fMRI, stereo EEG language mapping, and Wada in Spanish. He was seizure-free 6months post selective left temporal resection. He recently completed his1-year post-op evaluation. Baseline testing indicated average neurocognitive functioning, with select relative weaknesses lacking strong evidence for lateralization/localization. Post-operative consultation/ evaluation at 6 and 12months, respectively, revealed the patient was doing well academically with perceived improvements in attention and memory and minimal language difficulties. Reported improvements in mood were attributed to family reunification and increased social engagement. In addition to pre/post-surgical assessment in Spanish, bilingual neuropsychologists are uniquely positioned to contribute to the establishment of culturally-informed, standardized approaches to essential aspects of the presurgical workup (e.g., language mapping, Wada).