The Neuropsychology of Degenerative Brain Diseases

Now aged 34, Peter has been diagnosed as having multiple sclerosis for the past six years. His first symptom was the paralysis of his right arm. Loss of function developed over several days and then slowly improved. A year later both the right arm and leg were severely affected. This time the symptoms persisted and he was left with an ataxic gait and a loss of power in his arm. Shortly afterwards, Peter reported hailing persistent double vision and although this disappeared, a diagnosis of multiple sclerosis was made. Three years later, both Peter and his wife noticed that he was having difficulties remembering things. His cognitive problems precipitated a referral for neuropsychological testing. On the WAIS, Peter is found to have an IQ of 107 and on the WMS, an MQ of 93. He has noticeable problems with the Paired Associate and Logical Memory subtests.

His most pressing problems, however, are with his marriage. He no longer has a job, and his intense frustration at his physical problems leads to constant arguments with his wife, Christine. He feels that she controls every aspect of his life, treating him more like a child than a partner. Christine maintains that if she did not take charge of things, his poor memory and disinhibited behavior would compromise their personal circumstances further. Both are worried about the future and concerned about whether they should plan to have a family.

Multiple sclerosis (MS), once known as disseminated sclerosis, is the most common nontraurnatic neurological disease afflicting young adults in the Occident. For example, in a national survey Baum and Rothschild ( 1981) estimated that there were some 123,000 persons with MS in the United States on January 1st, 1976; a prevalence rate of 58/100,000 population. This disease, which commonly begins in the third and fourth

-131-