Gus A Baker

In this chapter, we consider the nature of neuropsychological examination, including the use of standard tests and development of a clinical formulation. The report was prepared on behalf of the court in compliance with Part 35 of the Civil Procedure Rules (CPR), for the purpose of a claim of personal injury that occurred on February 2018. We offer guidance on the interpretation of such neuropsychological tests and assessment of their validity. We also highlight a number of non-injury-related factors which may bear on the results obtained from testing and how these factors may contribute to the conclusions drawn. We conclude this discussion with the description of a real-life case study, claimant AM, which we hope will highlight the complexities faced in trying to provide a meaningful conclusion to the courts. The claimant was referred by their instructing solicitor who provided instructions for a neuropsychological assessment to document the claimant’s brain injury.

The use of expert witness testimony in courts is not new, with reports of expert witnesses being used since the 14th century (Wigmore 1978). Although not reported to have been the first psychologist to give expert witness testimony, Professor Hugo Münsterberg was one of the first to document psychological evidence in the courtroom in his publication On the Witness Stand: Essays on Psychology and Crime (1909). Since then, psychologist expert witnesses have regularly been used to provide expert witness testimony in cases such as criminal trials, child protection and family proceedings and personal injury cases (Wilcox and Craig 2018).

Neurological conditions are the leading cause of death and disability combined. This public health crisis has become a global priority with the introduction of WHO's Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders 2022–2031 (IGAP). 18 months after this plan was adopted, global neurology stakeholders, including representatives of the OneNeurology Partnership (a consortium uniting global neurology organisations), take stock and advocate for urgent acceleration of IGAP implementation. Drawing on lessons from relevant global health contexts, this Health Policy identifies two priority IGAP targets to expedite national delivery of the entire 10-year plan: namely, to update national policies and plans, and to create awareness campaigns and advocacy programmes for neurological conditions and brain health. To ensure rapid attainment of the identified priority targets, six strategic drivers …

ObjectiveIn the current era of the World Health Organization's Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders 2022–2031 (IGAP), precise and updated estimates of epilepsy burden are vital in formulating policies to improve the care of persons with epilepsy, especially in Asian countries with significant treatment gap. Hence, we aimed to consolidate the available data and quantify epilepsy prevalence and incidence estimates in Asian countries.MethodsWe systematically searched PubMed, Embase, Ovid, and Scopus databases from inception until March 2023 for studies reporting epilepsy prevalence and incidence in Asian countries. We applied random effects meta-analysis to generate the pooled prevalence and incidence using the Meta package in R. Additionally, we performed a subgroup meta-analysis to explore the potential sources of heterogeneity. A meta-regression analysis …

Our report on the IQ of children exposed to antiepileptic drugs in utero fails to adequately define the gestational timing of drug dose. We regret this omission. For each drug the dose quoted is prescribed before conception. The choice of 800 mg/day as an upper limit to'low dose'of valproate was based on the distribution of doses in the valproate-treated group.The second highlighted issue relates to conflicting conclusions about the influence of folic acid supplementation on the IQ of the child. In the UK study,[2] we found no difference in the IQ of children between those whose mothers had received'pre-conceptual'folic acid and those who had not. The NEAD study,[3] however, reported higher IQ levels in those children whose mothers had received'peri-conceptual'folic acid.

Plan on Epilepsy and Other Neurological Disorders 2022–2031 (IGAP), committing to ‘‘reduce the stigma, impact and burden of neurological disorders,[...] and improve the quality of life of people with neurological disorders, their carers and families”[1]. While calling on Member States to strengthen the public health approach to epilepsy, as a specific strategic objective–which will be explored further below–IGAP takes a multipronged, person-centered, human rights, and life course approach to brain health and all neurological conditions. Concretely, WHO has proclaimed a decade of action against a growing public health crisis: Neurological conditions have become the leading cause of death and disability combined [2]. This alarming trend is accelerated by population growth, aging societies, lifestyle changes, and factors including post-COVID conditions, environmental pollution, and climate change [2]. At least one …

Psychosocial burden of epilepsy is crucial in the care of epilepsy. Traditionally the effort to overcome the psychosocial burden of people with epilepsy has been by reducing social stigma but less on selfperceived stigma. Self-perceived stigma is an aspect of self-esteem and dignity. Maslow has divided the self-esteem and dignity into the" lower" and" higher" version. The" lower" version is the respect from others. The" higher" version is from self-evaluation. Thus, the approach to reduce stigma works toward" lower" version of esteem. A comprehensive approach to increasing esteem and dignity should thus also include efforts toward the" higher" version, to improve self-evaluation. In fact, enhancing self-esteem by reducing stigma also exert its effect through self-evaluation. As self-evaluation is dependent on cultural values, dialogue with the traditional culture, to draw out the relevant elements in the culture is a …

2022 marks an exceptional year for the global epilepsy community. Following over two decades of intensive global advocacy efforts at all levels [1], the 194 member states of the World Health Assembly unanimously adopted the World Health Organization (WHO) Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders 2022–2031 (IGAP)[2]. With five strategic objectives and 10 global targets, IGAP’s declared 10-year goal is to “reduce the stigma, impact and burden of neurological disorders, including their associated mortality, morbidity and disability, and to improve the quality of life of people with neurological disorders, their carers and families”[2]. Accordingly, this holistic global framework offers specific recommendations for concerted actions to be taken by the member states and their governments, the WHO Secretariat, as well as relevant national and international non-state actors. Guided …

BackgroundA Core Outcome Set (COS) is a standardised list of outcomes that should be reported as a minimum in all clinical trials. In epilepsy, the choice of outcomes varies widely among existing studies, particularly in clinical trials. This diminishes opportunities for informed decision-making, contributes to research waste and is a barrier to integrating findings in systematic reviews and meta-analyses. Furthermore, the outcomes currently being measured may not reflect what is important to people with epilepsy.Therefore, we aim to develop a COS specific to clinical effectiveness research for adults with epilepsy using Delphi consensus methodology.MethodsThe EPSET Study will comprise of three phases and follow the core methodological principles as outlined by the Core Outcome Measures in Effectiveness Trials (COMET) Initiative. Phase 1 will include two focused literature reviews to identify candidate …

The multitude of training models and curricula for the specialty of clinical neuropsychology around the world has led to organized activities to develop a framework of core competencies to ensure sufficient expertise among entry-level professionals in the field. The Standing Committee on Clinical Neuropsychology of the European Federation of Psychologists’ Associations is currently working toward developing a specialty certification in clinical neuropsychology to establish a cross-national standard against which to measure levels of equivalency and uniformity in competence and service provision among professionals in the field. Through structured interviews with experts from 28 European countries, we explored potential areas of core competency. Specifically, questions pertained to the perceived importance of a series of foundational, functional, and other competencies, as well as current training standards and practices, and optimal standards. Our findings revealed considerable agreement (about three quarters and above) on academic and clinical training, despite varied actual training requirements currently, with fewer respondents relegating importance to training in teaching, supervision, and research (a little over half), and even fewer to skills related to management, administration, and advocacy (fewer than half). European expert clinical neuropsychologists were in agreement with previous studies (including those conducted in the United States, Australia, and other countries) regarding the importance of sound theoretical and clinical training but management, administrative, and advocacy skills were not central to their perspective of a …

Recent guidelines from the International League Against Epilepsy (ILAE) delineating the role of the neuropsychologist in the assessment of epilepsy surgery patients stress the collaborative contribution neuropsychologists should make to seizure characterization, lateralization and localization in the pre-surgical setting. The role they should play in the comprehensive counselling of surgical candidates, including exploration of the patient’s expectations of surgical treatment is also mandated. In this paper we present two contrasting case studies which illustrate the importance of these roles and the impact they can have on patient outcomes. In Case A we describe the patient journey of a 69-year-old women with left hippocampal sclerosis and concordant neurophysiology and seizure semiology. We present the series of discussions and decisions which led her to reject the surgical option following a detailed exploration …

An increasing proportion of cognitive difficulties are recognized to have a functional cause, the chief clinical indicator of which is internal inconsistency. When these symptoms are impairing or distressing, and not better explained by other disorders, this can be conceptualized as a cognitive variant of functional neurological disorder, termed functional cognitive disorder (FCD). FCD is likely very common in clinical practice but may be under-diagnosed. Clinicians in many settings make liberal use of the descriptive term mild cognitive impairment (MCI) for those with cognitive difficulties not impairing enough to qualify as dementia. However, MCI is an aetiology-neutral description, which therefore includes patients with a wide range of underlying causes. Consequently, a proportion of MCI cases are due to non-neurodegenerative processes, including FCD. Indeed, significant numbers of patients diagnosed with MCI …

Parts of this chapter have been reproduced from Marson et al. 74 This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons. org/licenses/by/4.0/. The text below includes minor additions and formatting changes to the original text.

Quality of life and stigma in persons with epilepsy across Europe - the European Study on the Burden and Care of Epilepsy Study — PMU Research Portal Skip to main navigation Skip to search Skip to main content PMU Research Portal Home PMU Research Portal Logo Help & FAQ English Deutsch Home Research units Profiles Research output Projects Prizes Activities Press/Media Search by expertise, name or affiliation Quality of life and stigma in persons with epilepsy across Europe - the European Study on the Burden and Care of Epilepsy Study J Christensen, YL Sun, C Linehan, T Tomson, A Marson, L Forsgren, Eugen Trinka, C Iliescu, A Benson, A Gunko, JA Sonderup, JDC Sandu, M Leanca, Lucas Rainer, Teia Kobulashvili, C Granbichler, K Malmgren, J Kjellberg, PJ Jennum, S NevittG Baker Show 1 more Show less Department of Neurology Department of Psychiatry and Psychotherapy Research output: …

The aims of the SANAD II trial were to assess the longer-term clinical effectiveness and costeffectiveness of levetiracetam and zonisamide compared with lamotrigine in focal epilepsy, and of levetiracetam compared with valproate for generalised or unclassifiable epilepsy, in an unblinded randomised controlled trial.

Guidance on the Assessment of Performance Validity in Neuropsychological Assessments - Enlighten Publications Skip to main content Accessibility information Site navigation Study Research About us Student life Alumni Support us Contact Site tools AZ Lists Subjects AZ Staff AZ Academic units AZ University of Glasgow logo Home Enlighten Publications Enlighten Publications About Latest Additions Search Browse Browse by Author Browse by Year Browse by Journal Browse by Research Funder Name Browse by Colleges/Schools Open Access ORCID My Publications Login Guidance on the Assessment of Performance Validity in Neuropsychological Assessments Moore, P., Bunnage, M., Kemp, S., Dorris, L. and Baker, G. (2021) Guidance on the Assessment of Performance Validity in Neuropsychological Assessments. Documentation. British Psychological Society. Full text not currently available from Enlighten. …

Objective This study aimed to determine the prevalence of epilepsy in four European countries (Austria, Denmark, Ireland, and Romania) employing a standard methodology. The study was conducted under the auspices of ESBACE (European Study on the Burden and Care of Epilepsy). Methods All hospitals and general practitioners serving a region of at least 50 000 persons in each country were asked to identify patients living in the region who had a diagnosis of epilepsy or experienced a single unprovoked seizure. Medical records were accessed, where available, to complete a standardized case report form. Data were sought on seizure frequency, seizure type, investigations, etiology, comorbidities, and use of antiseizure medication. Cases were validated in each country, and the degree of certainty was graded as definite, probable, or suspect cases. Results From a total population of 237 757 in the four …

Guidance on the recording of neuropsychological testing in medicolegal settings - Enlighten Publications Skip to main content Accessibility information Site navigation Study Research About us Student life Alumni Support us Contact Site tools AZ Lists Subjects AZ Staff AZ Academic units AZ University of Glasgow logo Home Enlighten Publications Enlighten Publications About Latest Additions Search Browse Browse by Author Browse by Year Browse by Journal Browse by Research Funder Name Browse by Colleges/Schools Open Access ORCID My Publications Login Guidance on the recording of neuropsychological testing in medicolegal settings Baker, GA, Kemp, S., Bunnage, M., Dorris, L. , Moore, P. and Wright, I. (2021) Guidance on the recording of neuropsychological testing in medicolegal settings. Documentation. British Psychological Society, Leicester. Full text not currently available from Enlighten. …

This study analyzed aspects of the work of clinical neuropsychologists across Europe. There are no published comparisons between European countries regarding the nature of clinical neuropsychologists’ work. Forty-one national psychological and neuropsychological societies were approached, of which 31 (76%) responded. Data from seven countries with less than 10 neuropsychologists were excluded. A license is required to practice clinical neuropsychology in 50% of the countries. Clinical neuropsychologists work independently in 62.5%. Diagnostic/assessment work is the most frequently reported activity (54%). Most neuropsychologists work in public hospitals, followed by health centers. Adult neuropsychology was the most frequent area of activity. Services in public institutions are covered by public entities (45.8%), or by a combination of patient funds and public entities (29.2%) and only 4.2% by the patient; whereas services in private institutions are covered by the patient (26.1%) and the combination of patient, public entities (21.7%) or patient and private entities (17.4%). The data suggest that the number of neuropsychologists working across European countries is considerably low in comparison to other medical professionals. The results of the survey identified similar aspects of neuropsychologists’ work, despite variations in terms of reimbursement and mechanisms, reflecting economic and healthcare differences. Estimates on the number of clinical neuropsychologists suggest insufficient access to neuropsychological services.

BackgroundLevetiracetam and zonisamide are licensed as monotherapy for patients with focal epilepsy, but there is uncertainty as to whether they should be recommended as first-line treatments because of insufficient evidence of clinical effectiveness and cost-effectiveness. We aimed to assess the long-term clinical effectiveness and cost-effectiveness of levetiracetam and zonisamide compared with lamotrigine in people with newly diagnosed focal epilepsy.MethodsThis randomised, open-label, controlled trial compared levetiracetam and zonisamide with lamotrigine as first-line treatment for patients with newly diagnosed focal epilepsy. Adult and paediatric neurology services across the UK recruited participants aged 5 years or older (with no upper age limit) with two or more unprovoked focal seizures. Participants were randomly allocated (1:1:1) using a minimisation programme with a random element utilising …