Double disassociation of anosognosia for alexia and simultanagnosia but quantitative awareness of optic ataxia

Reed C. Williams, Riddhi Patira, Eric L. Altschuler

Research output: Contribution to journalArticle

Abstract

A 66-yr-old man with a history of atrial fibrillation and a pacemaker developed sudden onset confusion, disorientation, and visual disturbance without motor weakness. Clinically, significant deficits were found in reading (alexia) and simultaneous multiobject perception (simultanagnosia), both of which the patient denied limitation in, and in visionVright hemianopsiaVwhich he readily acknowledged. Visual acuity in the left visual field was normal. The patient also demonstrated a symptom of optic ataxiaVa lack of coordination between visual inputs and hand movementsVa deficit he also acknowledged.Work-up with computed topography revealed a left posterior cerebral artery infarct affecting the occipital lobe and extending to involve the parietal lobe and the splenium of the corpus callosum. The authors describe and discuss this fascinating caseVthe first case to their knowledge of a double disassociation of anosognosia for alexia and simultanagnosia but full, indeed quantitative, awareness of hemianopsia and optic ataxia. This case may be informative on the mechanism of anosognosia in general and supports intentional feed-forward and exemplar reafference models. With regard to the rehabilitation process, appreciation that a patient has anosognosia for various deficits is crucial in recovery and health maintenance.

Original languageEnglish (US)
Pages (from-to)230-234
Number of pages5
JournalAmerican Journal of Physical Medicine and Rehabilitation
Volume95
Issue number3
DOIs
StatePublished - Sep 11 2015
Externally publishedYes

Keywords

  • Agraphia
  • Alexia
  • Anosognosia
  • Balint Syndrome
  • Oculomotor Apraxia
  • Optic Ataxia
  • Simultanagnosia

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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