Where is the lesion in allochiria?
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Brain Diseases↗
Biomedical subjects
D F Benson
Publications and source records attributed to D F Benson.
Dissociation of color from object in amnesia.
A patient with persistent amnesia after bilateral medial temporal and left inferotemporo-occipital infarction could not match colors to objects in verbal, visual, or visuoverbal tasks. A severe naming disorder for objects was present but the patient could name colors and point to colors whose name was given. The matching disorder appeared to be a deficit in the semantic classification of objects rather than a problem in identifying colors.
Aged↗
Prosopagnosia: a bihemispheric disorder.
A 54-year-old, right-handed male suffered three sequential infarcts. The first two destroyed much of the right posterior parietal area, the posterior-medial portion of the right temporal lobe and virtually the entire right occipital lobe producing left homonymous hemianopsia and left visual neglect but no prosopagnosia. A third vascular accident involved the left parieto-occipital lobe and immediately produced prosopagnosia that has persisted. The sequential correlations of lesion and symptomatology in this case demonstrate that development of persistent prosopagnosia occurred only after bilateral damage.
Agnosia↗
Cerebral symptoms after whiplash injury of the neck: a prospective clinical and neuropsychological study of whiplash injury.
Twenty one unselected patients with an acute whiplash injury of the neck had neurological and neuropsychological assessment, cervical x rays, EEG, BAEP, MRI, and an otoneurological examination within two weeks of the injury. Subjectively, 13 patients reported concentration deficits, 18 reported sleep disturbances, 9 had symptoms of depression, and 7 female patients told of menstrual irregularities. Neuropsychological examination revealed significantly lower performance in tests related to attention and concentration compared to sex, age and educational matched control subjects. Otoneurological examination showed abnormalities in 9 of 17 whiplash subjects. EEG showed questionable changes in 8 of 18 recordings. MRI and BAEP were normal in all patients. Repeat neuropsychological testing in 15 patients at three months showed that attention deficits had improved but were still shown in 12 of 14 and the concentration deficits in 8 of 13 patients. At one year all patients had returned to work, 16 to full and 5 to part time employment. In 4, cognitive dysfunction remained the only significant problem. These findings are discussed as being compatible with possible damage to basal frontal and upper brain stem structures after whiplash injury of the neck.
Adolescent↗
A quantitative MRI study of vascular dementia.
We studied the MRI and clinical factors associated with dementia following stroke by quantifying ventricle-to-brain ratio (VBR), anatomic region of infarction, and cortical, subcortical, and white matter areas of infarction in 24 stroke patients with dementia and 29 nondemented stroke patients. The factors that most strongly correlated with dementia were total white matter lesion (WML) area, left WML, VBR, right WML, age, left cortical infarction area, left parietal infarction area, and total infarction area. Using discriminant analysis, these factors correctly classified 28 of 29 nondemented patients and 18 of 24 demented patients. Both cortical and white matter total infarction area measurements were strongly associated with dementia in stroke patients, suggesting that these factors strongly influenced the development of dementia following stroke. There was a strong association between dementia and left- but not right-hemisphere infarction area. The only demographic factor that strongly associated with dementia was age.
Aged↗
Creutzfeldt-Jakob disease in a pathologist.
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Aged↗
Slowly progressive aphasia: three cases with language, memory, CT and PET data.
Three cases of slowly progressive speech and language disturbance were studied at various points post onset (three, five and 15 years respectively). Language, neuropsychological and brain imaging (computer tomography and positron emission tomography) evaluations were completed on all three patients. The data suggest that the syndrome of "progressive aphasia": 1) does not involve a uniform symptom complex; 2) does not necessarily develop into a full blown dementia syndrome; 3) varies greatly in rate of progression from case to case; 4) is associated with normal brain structure (on computer tomography); and 5) is associated with abnormal left temporal lobe metabolism as measured by fluorodeoxyglucose (FDG) positron emission tomography (PET). One patient had histological findings consistent with Alzheimer's disease at necropsy.
Aged↗
Some aspects of language comprehension in anterior aphasia.
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Aphasia↗
Left-to-right transfer of language dominance: a case study.
Partial recovery from aphasia was documented in an individual rendered hemiplegic and globally aphasic by embolic infarction in the distribution of the left middle cerebral artery. Computed tomography showed total destruction of the classical left hemisphere language areas, indicating that the right hemisphere was responsible for the improved linguistic function. This observation is consistent with right hemisphere language capacity demonstrated after left hemispherectomy or commissurotomy. Right hemisphere language function may underlie much of the recovery from aphasia after injury of the left hemisphere.
Aphasia↗
Poriomania.
Three patients with complex partial seizures experienced prolonged episodes of aimless wandering followed by retrograde amnesia for the experience, a phenomenon called poriomania. Our experience and the literature suggest that this behavior is a prolonged postictal automatism and is not psychogenic. Adjustments of anticonvulsant therapy eliminated this behavior in all three of our patients.
Amnesia, Retrograde↗
Capgras syndrome: a reduplicative phenomenon.
A patient recovering from a severe head injury developed a prolonged Capgras syndrome in which he believed his wife and five children had been replaced by nearly identical substitutes. Although this phenomenon is considered a functional disorder in the psychiatric literature, recent reports postulate an organic basis. Recent studies of the comparable neurologic disorder, reduplicative paramnesia, have stressed the importance of bilateral frontal and right hemisphere pathology. Neuropsychologic and neuroradiologic data in our patient revealed this combination, suggesting that the Capgras syndrome may be a form of reduplicative paramnesia with the same pathologic substrate.
Adult↗
Phantom limb and multiple sclerosis.
Phantom limb phenomena are most often associated with amputations, although they may accompany many neurologic disorders. In the neurologic variety, expression of illusory limbs varies with the level at which the somesthetic pathway is interrupted, and with changes in consciousness. Phantom limb illusions are rarely reported in patients with multiple sclerosis (MS). The patient reported here complained of a supernumerary phantom limb during an exacerbation of MS. This case suggests that in neurologic diseases, phantom limb illusions may result from distorted perception of limbs that are subject to both sensory loss and such recurrent spontaneous sensations as paresthesias.
Adult↗
Amnesia.
Amnesia is a common clinical problem characterized by four features: (1) normal immediate recall, (2) impaired ability to learn, (3) relatively spared ability to retrieve previously learned material, and (4) preserved cognitive and personality characteristics. Amnesia occurs as a distinct mental disorder, and nine variations seen clinically are described here: Korsakoff's psychosis, posttraumatic amnesia, amnesia stroke, postoperative amnesia, postinfectious amnesia, anoxic amnesia, transient global amnesia following ECT, and psychogenic amnesia. The clinical findings which characterize and differentiate these disorders are presented, along with suggestions for management and a discussion of the the outcome of amnesia.
Alcohol Amnestic Disorder↗
The third alexia.
A variety of alexia has been demonstrated that can be distinguished from the two classically recognized types of alexia. This reading disorder is seen in patients with a dominant frontal lobe pathologic condition that has produced a motor language disturbance (Broca aphasia) and is sufficiently disabling to deserve consideration as a variety of alexia. Functionally, the frontal reading disturbance differs from the other two types in that the patient comprehends meaningful content words better than relational or syntactic structures. Four factors that may underly frontal alexia have been noted: (1) gaze paresis, (2) inability to maintain verbal sequences; (3) inability to comprehend syntactic structure, and (4) literal alexia.
Agraphia↗
A study of confabulation.
Confabulation consequent to organic amnesia is a well-described clinical finding. A number of plausible theories of confabulation have been proposed, but the various claims and counterclaims have not been systematically tested. A standardized test battery that included four different kinds of questions plus measures of suggestibility and the tendency to utilize external cues was administered to ten amnesic patients who demonstrated varying degrees of confabulation. One additional patient, whose clinical condition changed dramatically during his hospital course, received the battery on a number of occasions. Differences among patients were found in overall performance, degree of confabulation, and ability to use cues. Hypothesized relationships between confabulation and suggestibility, degree of memory disorder, and degree of disorientation were not confirmed. However, confabulation proved to be strongly related to the inability to withhold answers, to monitor one's own responses and to provide verbal self-corrections. These results suggest a tentative model of the process of confabulation as well as a number of useful clinical signs indicationg recovery from amnesia.
Adult↗