Pamela S. Klonoff, PhD Clinical Director Center for Transitional Neuro-Rehabilitation Barrow Neurological Institute, Phoenix, Arizona

Transcription

1 Neuropsychology Pamela S. Klonoff, PhD Clinical Director Center for Transitional Neuro-Rehabilitation Barrow Neurological Institute, Phoenix, Arizona Top Ten Ways to Understand and Cope with a Brain Tumor 1. Become knowledgeable about your tumor diagnosis, treatment procedures and options, prognosis and complications (e.g., seizures). - research the specialization and credentials of your physician - don t be afraid to ask questions - write down questions prior to your appointments and answers/recommendations during the appointments. 2. Understand the potential cognitive, personality, physical and language changes: (general review of basic neuroanatomy: frontal, temporal, parietal, and occipital lobes) - Divisions of the brain: a.) Hemispheres: these are the two sides, left and right. Left Hemisphere Right Hemisphere - Language skills - Visuospatial processing (speaking, reading, etc.) (mechanical skills) - Mathematical skills - Musical ability - Attention to detail b.) Lobes: each hemisphere has four lobes - frontal - temporal - parietal - occipital c.) Other structures of the brain: - Cerebellum: located under the lobes and behind the brain stem. It is important for motor function, balance, and coordination. Page 1 of 5

2 - Brain Stem: a primitive part of the brain important for motor function and alertness. It also regulates basic vegetative functions, such as breathing, heartbeat, and temperature. Parietal Lobe Frontal Lobes Occipital Lobe Temporal Lobe Cerebellum Brain stem Page 2 of 5 Frontal lobes are responsible for: a) judgment, decision-making ("executive" functions) b) starting and stopping (initiation and inhibition) c) personality d) abstract thinking e) voluntary movement (on opposite sides of the body) f) voluntary speech a) "acting without thinking" (impulsivity) b) difficulty starting an action (initiation deficits) c) difficulty stopping an action (perseveration) d) inappropriate social behavior (disinhibition)

3 e) excessive talking (verbosity) f) wandering off topic (tangentiality) g) unawareness of the effects of the injury h) poor judgment or decision-making i) difficulty "seeing the big picture" (concrete thinking) j) difficulty with planning and organization k) motor deficits l) speech and language production deficits (aphasia) m) reduced emotional control (see c) n) flattened affect Temporal lobes are responsible for: a) memory (verbal memory in left hemisphere) (visual memory in right hemisphere) b) hearing and auditory processing c) language comprehension (L) a) deficits in the ability to transfer information to long-term memory b) difficulty understanding language (aphasia) c) auditory processing impairments d) suspiciousness e) visual processing (because fibers pass through temporal lobes on their way to the occipital lobes) Parietal lobes are responsible for: a) mechanical and construction skills (R) b) visual attention (R) c) visual-spatial processing (R) d) right/left orientation (L) e) language and reading comprehension (L) f) math (L) g) sensation (on opposite sides of the body) a) reduced attention to one side of space (visual neglect) Page 3 of 5

4 b) impaired sensation c) reading, writing, and spelling deficits (left side) d) difficulty telling left from right e) impaired sense of direction f) visuospatial processing difficulties g) mathematical deficits h) word-finding deficits (anomia) i) mechanical deficits Occipital lobes are responsible for: a) visual processing a) visual field cut (hemianopsia) b) visual processing difficulties 3. Recognize there may be common thinking problems: - a) attention and concentration; - b) slower speed of information processing; - c) problem solving and reasoning; and 4. Memory changes are extremely common: - Memory: usually affects new learning. Examples of memory problems include: - Difficulty learning new information; - Difficulty learning a new skill; - Other examples of problems include: - repeating a question or story to the same person; - forgetting to do things (e.g., appointments, household chores) - forgetting a change in routine; - forgetting where you placed something; - getting lost - (old, well-learned information is usually preserved). 5. It is important to learn to be as independent as possible and to compensate for problem areas. - With memory problems there are many excellent tools to help you: Page 4 of 5

5 - the Datebook, Palm Pilot, checklists, watch alarms, pillbox - It helps to set and stick to routines and schedules. It is VERY IMPORTANT to remember to take medications at designated times. - Be careful not to become too reliant on family members to compensate for your memory and other problems. - This leads to burn out in your family and increased likelihood of feelings of helplessness and low self-esteem in you as patients. 6. Patients usually experience emotional/personality changes CAUSED by neurochemical and physiological changes in brain function. Examples of these are: - Emotional lability (emotions closer to the surface; low frustration tolerance or irritability; depression.) Emotional changes also happen IN REACTION to the life changes caused by the brain tumor. (Examples are depression, feeling overwhelmed and feelings of loss). 7. Recognize that brain tumors are a family affair your spouse and children will have feelings about what has happened to you - They may benefit from emotional support/education (e.g., psychologists, psychiatrists, social workers, school counselors) 8. Emphasize quality of life focus on relationships and interests 9. Plan for the future regarding work, hobbies, personal affairs (find the balance between optimism and realistic planning). 10. Don t be afraid to seek professional help for problems. a. Ask your physician about potential resources (e.g., rehabilitation - Physical Therapy, Occupational Therapy, Speech Therapy, Neuropsychology) b. Tumor support groups (with web sites for resources) Pamela S. Klonoff, PhD Dr. Pamela Klonoff is the clinical director of the Center for Transitional Neuro- Rehabilitation at Barrow Neurological Institute in Phoenix, Arizona. Dr. Klonoff can be reached at ccarper@chw.edu Page 5 of 5