25 KB1137 KB22 KB200820252012Starovasnik, Barbaraletnik:11številka:supl. 1COBISSID:1537641ISSN:1580-9315URN:URN:NBN:SI:doc-C88UYFRTslUniverzitetni rehabilitacijski inštitut Slovenije - SočaRehabilitacija (Ljubljana)AgnosiaagnozijaanosognosiaanozognozijaDiagnosis, Differentialdiferencialna diagnostikaneuropsychological rehabilitationnevropsihološka rehabilitacijaNevropsihološka diagnostika sposobnosti prepoznavanja in celostnega združevanja informacij - možnosti za ocenjevanje, trening in kognitivno nevrorehabilitacijo| Neuropsychological assessment of recognition ability and complex integration of information - possibilities for assessment, training and cognitive rehabilitation|Agnosias develop when the meaning is striped from a percept, and there are problems associated with the cortical processing of stimuli which are not related to or can be explained by deficits in the sensory organ. Traditionally, a distinction between apperceptive and associative forms of agnosia has been made, and due to some modality specifics several types of agnosia have been identified (visual, auditory, tactile). Anosognosia refers to patients suffering from various neurological impairments who deny or lack awareness of their deficits, although these deficits may have serious consequences in their everyday life, rehabilitation process and/or their recovery from initial disease. We are still not aware of any controlled study of therapy for anosognosia in cases of, for example, hemiplegia. Rather, patients should be examined to determine the extent and the nature of their complete syndrome of impaired awareness individually or as group therapy settings. Neuropsychological assessment has two fundamental goals. First, the possibility that recognition disturbance exists because of some other co-existing impairment, which should be ruled out with standardized neuropsychological testing instruments. Second, the scope and nature of the patient's recognition disturbance should also be assessed and determined. Key symptoms, characteristic neuroradiological findings, and a general neuropsychological approach based on cognitive neuropsychological models of object recognition is an important differential and diagnostic tool. Although significant progress has recently been made, much remains to be learned and explored about these complex disordersAgnozije so motnje ocenjevanja in prepoznavanja lastnosti in značilnosti senzoričnega dražljaja, ki jih ni mogoče pojasniti s pomanjkljivim delovanjem senzoričnih organov. V grobem jih ločimo na aperceptivne in asociativne ter glede na senzorično modalnost (vizualne, slušne in taktilne). Še posebej pomembna v procesu celostne rehabilitacije je motnja sposobnosti prepoznavanja posledic bolezni, pri kateri bolnik nima vpogleda v posamezne lastne telesne okvare ali celo popolnoma zanemari oz. zanika posledice svojega zdravstvenega stanja in jo imenujemo anozognozija. Dokazano učinkovitih ali posebnih terapevtskih pristopov k zdravljenju tovrstnih motenj za enkrat še ne poznamo, obravnava le-teh je usmerjena dolgoročno ter kombinira individualni in skupinski terapevtski pristop. Nevropsihološka diagnostika je pred načrtovanjem kognitivne nevrorehabilitacije ključnega pomena in zajema tako izključevanje drugih možnih razlogov bolnikovega kognitivnega stanja kot tudi objektivno določitev značilnosti in stopnje oškodovanosti posamezne motnje. Za učinkovito diferencialno diagnostično oceno je potrebno upoštevati ključne simptome, morebitne značilne nevroradiološke ugotovitve ter bolnikovo nevropsihološko stanje, senopredeljeno po določenih nevropsiholoških smernicah in modelih. Navkljub razmeroma pomembnim dognanjem pa v zadnjih letih omenjeno področje sposobnosti prepoznavanja in celostnega združevanja informacij še vedno ostaja manj raziskano in s kliničnimi študijami podprto področje kliničnega in terapevtsko rehabilitacijskega delaTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaUniverzitetni rehabilitacijski inštitut RS – Soča