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CC BY 4.0 · Arq Neuropsiquiatr 2023; 81(09): 835-843
DOI: 10.1055/s-0043-1770349
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Neuropsychology of epilepsy surgery and theory-based practice: an opinion review

Neuropsicologia da cirurgia de epilepsia e prática teórica: uma revisão de opinião
Panayiotis Patrikelis 
1   University of Athens, School of Medicine, Evangelismos Hospital, Epilepsy Surgery Unit, National and Kapodistrian 1st Department of Neurosurgery, Laboratory of Clinical Neuropsychology, Athens, Greece.
2   Aristotle University of Thessaloniki, School of Psychology, Faculty of Philosophy, Thessaloniki, Greece.
,
Lambros Messinis 
2   Aristotle University of Thessaloniki, School of Psychology, Faculty of Philosophy, Thessaloniki, Greece.
3   University Hospital of Patras, School of Medicine, Neuropsychology Section, Departments of Neurology and Psychiatry, Patras, Greece.
,
Vasileios Kimiskidis 
4   Aristotle University of Thessaloniki, School of Medicine, Faculty of Health Sciences, 1st Department of Neurology, Thessaloniki, Greece.
,
Stylianos Gatzonis 
1   University of Athens, School of Medicine, Evangelismos Hospital, Epilepsy Surgery Unit, National and Kapodistrian 1st Department of Neurosurgery, Laboratory of Clinical Neuropsychology, Athens, Greece.
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Abstract

The present review attempts to discuss how some of the central concepts from the Lurian corpus of theories are relevant to the modern neuropsychology of epilepsy and epilepsy surgery. Through the lenses of the main Lurian concepts (such as the qualitative syndrome analysis), we discuss the barriers to clinical reasoning imposed by quadrant-based views of the brain, or even atheoretical, statistically-based and data-driven approaches. We further advice towards a systemic view inspired by Luria's clinical work and theorizing, given their importance towards our clinical practice, by contrasting it to the modular views when appropriate. Luria provided theory-guided methods of assessment and rehabilitation of higher cortical functions. Although his work did not specifically address epilepsy, his theory and clinical approaches actually apply to the whole neuropathology spectrum and accounting for the whole panorama of neurocognition. This holistic and systemic approach to the brain is consistent with the network approach of the neuroimaging era. As to epilepsy, the logic of cognitive functions organized into complex functional systems, contrary to modular views of the brain, heralds current knowledge of epilepsy as a network disease, as well as the concept of the functional deficit zone.

Resumo

A presente revisão tenta discutir como alguns dos conceitos centrais do corpus de teorias lurianas são relevantes para a moderna neuropsicologia da epilepsia e cirurgia da epilepsia. Através das lentes dos principais conceitos lurianos (como a análise qualitativa de síndromes), discutimos as barreiras ao raciocínio clínico impostas por visões do cérebro baseadas em quadrantes, ou mesmo abordagens ateóricas, baseadas em estatísticas e orientadas por dados. Aconselhamos ainda uma visão sistêmica inspirada na clínica e na teorização de Luria, dada sua importância para nossa prática clínica, contrastando-a com as visões modulares quando apropriado. Luria forneceu métodos teóricos de avaliação e reabilitação de funções corticais superiores. Embora seu trabalho não abordasse especificamente a epilepsia, sua teoria e abordagens clínicas na verdade se aplicam a todo o espectro da neuropatologia e respondem por todo o panorama da neurocognição. Essa abordagem holística e sistêmica do cérebro é consistente com a abordagem de rede da era da neuroimagem. Quanto à epilepsia, a lógica das funções cognitivas organizadas em sistemas funcionais complexos, ao contrário das visões modulares do cérebro, anuncia o conhecimento atual da epilepsia como uma doença em rede, bem como o conceito de zona de déficit funcional.

Keywords

Neuropsychology - Luria-Nebraska Neuropsychological Battery - Epilepsy - Neurosurgery - Information Theory

Palavras-chave

Neuropsicologia - Bateria Neuropsicológica de Luria-Nebraska - Epilepsia - Neurocirurgia - Teoria da Informação

Authors' Contributions

PP, SG: conceived the presented idea; VK, LM, have focused mainly on bibliographic documentation of the present work; All authors contributed to the final manuscript.




Publication History

Received: 19 August 2022

Accepted: 15 February 2023

Article published online:
04 October 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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