Developmental and acquired dysexecutive syndromes in clinical practice: three case-reports

Abstract

Dysexecutive syndromes are often observed in several neuropsychiatric conditions, such as attention deficit hyperactivity disorder (ADHD), traumatic brain injuries (TBI) or schizophrenia, and usually associate with significant impairments, including familial, academic and professional areas. The present paper aims at presenting three cases of executive functions (EFs) deficits where despite having normal IQ, all subjects' exhibit significant functional and social impairment. The first case describes a young woman who suffered a TBI and her complaints relates to difficulties in memory for new material, apathy, less persistency and initiative. The second case is about a middle-age woman facing problems since kindergarten and with unsuccessful treatments and no formal diagnosis. In this case, collateral report suggests the presence of planning difficulties, some antisocial behavior, delay gratification aversion, poor activation and time estimation deficits. The last case refers to a middle-age man, evaluated after a severe TBI following a car accident. He presented some behavioral changes, such as disinhibition, lack of persistency and inattentive deficits that occur in a more severe level than presented during his childhood, despite having normal performance in tests of EFs. The evaluation of (developmental or acquired) EF deficits might be extremely important for providing adequate therapeutic approach in order to decrease related impairments in everyday activities.