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

Objective: To determine the relation of neurology and neuropsychology to ev eryday competence. Design: The association of these three domains was investigated using a sin gle case multiple baseline design with two phases. Phase A comprised 6 week s that coincided with an inpatient admission. Phase B comprised 3 months sp ent at home. A battery of visual spatial tests was completed every Fortnigh t during the A phase and at the end of the B phase. Two new tests of releva nt neurologic function with control data were developed and used weekly dur ing 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 recorde d her depth perception. Setting: Tertiary care center. Participant: A 35-year-old woman who suffered a venous sinus thrombosis wit h visual disorientation syndrome. Results: During Phase A, she achieved significant functional gains in mobil ity, dressing, bathing, and domestic tasks, in the context of unchanging ps ychometric test scores and static relevant neurologic function. During Phas e B, she achieved few functional gains, despite improvements in neurologic status, demonstrated by depth perception. Conclusions: Everyday function can progress without improvement in neurolog ic and cognitive status.