Relation of impairment to everyday competence in visual disorientation syndrome: Evidence from a single case study

Abstract

Objective: To determine the relation of neurology and neuropsychology to everyday competence.Design: The association of these three domains was investigated using a single case multiple baseline design with two phases. Phase A comprised 6 weeks that coincided with an inpatient admission. Phase B comprised 3 months spent at home. A battery of visual spatial tests was completed every fortnight during the A phase and at the end of the B phase. Two new tests of relevant neurologic function with control data were developed and used weekly during the A phase and at the end of the B phase. The first test recorded the speed, accuracy, and efficiency of her walking, and the second test recorded her depth perception.Setting: Tertiary care center.Participant: A 35-year-old woman who suffered a venous sinus thrombosis with visual disorientation syndrome.Results: During Phase A, she achieved significant functional gains in mobility, dressing, bathing, and domestic tasks, in the context of unchanging psychometric test scores and static relevant neurologic function. During Phase B, she achieved few functional gains, despite improvements in neurologic status, demonstrated by depth perception.Conclusions: Everyday function can progress without improvement in neurologic and cognitive status.