Asymmetric oculomotor apraxia, optic ataxia, and simultanagnosia with right hemispatial neglect from a predominantly left-sided lesion of the parieto-occipital area. Issue 1 (2nd January 2018)

• Record Type: Journal Article
• Authors: Sakurai, Yasuhisa; Fujimoto, Masanori; Hamada, Kensuke; Sugimoto, Izumi
• Is Part Of: Cognitive neuropsychiatry. Volume 23:Issue 1(2018)
• Page Start: 1
• Page End: 14
• Publication Date: 2018-01-02
• Subjects: Bálint's syndrome; hemispatial neglect -- Trousseau's syndrome -- dorsal simultanagnosia -- optic ataxia; Neuropsychology -- Periodicals; 616.8
• DOI: 10.1080/13546805.2017.1407304
• Languages: English
• ISSNs: 1354-6805

Abstract

ABSTRACT: Introduction : Bálint's syndrome involves bilateral damage to the parieto-occipital area. The extent of the effect of unilateral damage on the Bálint's triad (oculomotor apraxia, optic ataxia, and simultanagnosia) remains unknown. Methods : We examined a 63-year-old, right-handed woman who developed right hemianopia, oculomotor apraxia, optic ataxia, simultanagnosia, and hemispatial neglect (HSN) for the right after a cerebral infarction, with detailed neuropsychological tests, magnetic resonance imaging, and single photon emission computed tomography (SPECT). Results : Neuropsychological examination showed that oculomotor apraxia, optic ataxia, and simultanagnosia were more pronounced in the right hemi-space, probably due to the limited eye movement in the right visual field, whereas HSN was restricted to the right hemi-space. Diffusion-weighted MR images revealed hyperintensity in the left parieto-temporo-occipital region, and several spotty areas of the bilateral frontal and parietal subcortical regions. SPECT revealed hypoperfusion in the left parieto-occipital region and frontal operculum and small areas of the right superior parietal lobule. Conclusions : The case suggests that asymmetric (more pronounced in the right hemi-space) oculomotor apraxia, optic ataxia, and simultanagnosia occur in an extensive lesion of the left parieto-occipital cortices. Although HSN is not a prerequisite for simultanagnosia, the coexistence of HSN aggravates simultanagnosia in the hemi-space opposite the lesion.