ABSTRACT
Simultanagnosia resulting from dorsal stream dysfunction is an under recognized condition. In this case report we describe the case of a young woman who developed posterior reversible encephalopathy syndrome (PRES), and who recovered visual acuities of 20/20 in each eye, along with normal visual fields and contrast sensitivities, yet experienced persistent symptoms of perceptual dysfunction. Detailed and systematic history taking revealed consistent visual difficulties typical of dorsal stream dysfunction. After a detailed explanation of her symptomatology and training in a range of strategies to cope, the patient experienced a great improvement in her day-to-day functioning.
ABSTRACT
Posterior cortical atrophy (PCA) is a kind of neurodegenerative dementia,which is characterized by the progressive decline of visuoperceptual,visuospatial,reading and writing ability and praxic skills.Neuroimaging usually shows atrophy or metabolic decrease in posterior brain regions.The most common neuropathologic changes of PCA are amyloid plaques deposition and neurofibrillary tangles in posterior cortex.In general,PCA is considered as a variant form of Alzheimer's disease.
ABSTRACT
Posterior cortical atrophy(PCA) is a presenile dementia that presents primarily with signs and symptoms of cortical visual dysfunction, while memory is relatively preserved until the late stage of the disease. We report a patient with PCA, confirmed by brain magnetic resonance imaging (MRI) and F18-fluorodeoxyglucose positron emission tomography(FDG PET). A 58-year-old right-handed woman presented initially with visual dimness and difficulty finding things around her. She had partial Balint's syndrome, partial Gerstmann syndrome, and idiomotor apraxia. She also had a mild memory disturbance, but preserved insight of her disease. Neuropsychological evaluation showed decreased parietal and left temporal functions bilaterally. Brain MRI and F18-FDG PET revealed typical bilateral occipitoparietal atrophy and hypometabolism, which were slightly worse on the right side. Cholinesterase inhibitor administration for 6 months improved the memory impairment slightly, but not the cortical visual dysfunction. This is a typical case of PCA, confirmed by neurologic signs and imaging findings.
Subject(s)
Female , Humans , Middle Aged , Alzheimer Disease , Apraxias , Atrophy , Brain , Cholinesterases , Dementia , Electrons , Gerstmann Syndrome , Glycogen Storage Disease Type VI , Magnetic Resonance Imaging , Memory , Neurologic Manifestations , Passive Cutaneous AnaphylaxisABSTRACT
Posterior cortical atrophy (PCA) is a subgroup of focal cortical atrophy with progressive degenerative dementia that begins with higher visual dysfunction. We present two patients with symptoms suggestive of PCA. They have mild memory impairment early in the course of disease and intact primary motor and sensory modalities. Parieto-occipital atrophy was evident on brain MRI in one patient and the other was suspicious. We think that these findings are consistent with posterior cortical atrophy which is variant of Alzheimer's disease.
Subject(s)
Humans , Alzheimer Disease , Atrophy , Brain , Dementia , Magnetic Resonance Imaging , Memory , Passive Cutaneous AnaphylaxisABSTRACT
A subgroup of patients with progressive degenerative dementia that begins with higher visual dysfunction has been referred to as posterior cortical atrophy (PCA). A 55-year-old woman presented with progressive visual disturbance for 4 years, which was followed by geographical disorientation, impairment of writing and calculation, and memory distur-bance. Neuropsychological deficits were characterized by Balint syndrome, visuospatial dysfunction, prosopagnosia, Gerstmann syndrome and apraxia. Brain MRI showed mild diffuse atrophy. F18-FDG-PET disclosed bilateral occipi-totemporoparietal hypometabolism, more pronounced on the right. Biopsy from right temporal lobe revealed neu-ropathological findings consistent with Alzheimer's disease.
Subject(s)
Female , Humans , Middle Aged , Alzheimer Disease , Apraxias , Atrophy , Biopsy , Brain , Dementia , Gerstmann Syndrome , Magnetic Resonance Imaging , Memory , Prosopagnosia , Temporal Lobe , WritingABSTRACT
A subgroup of patients with progressive degenerative dementia that begins with higher visual dysfunction has been referred to as posterior cortical atrophy (PCA). A 55-year-old woman presented with progressive visual disturbance for 4 years, which was followed by geographical disorientation, impairment of writing and calculation, and memory distur-bance. Neuropsychological deficits were characterized by Balint syndrome, visuospatial dysfunction, prosopagnosia, Gerstmann syndrome and apraxia. Brain MRI showed mild diffuse atrophy. F18-FDG-PET disclosed bilateral occipi-totemporoparietal hypometabolism, more pronounced on the right. Biopsy from right temporal lobe revealed neu-ropathological findings consistent with Alzheimer's disease.