28 - 10. Other neurological deficits

10. Other neurological deficits

© SPMM Course 10. Other neurological deficits Acalculia refers to the inability to read, write, and comprehend numbers. It is NOT the same as anarithmetrica, which is the inability to perform arithmetical calculations. Acalculia can be tested using the simple calculation, writing numbers to dictation, copy numbers and read them aloud, and give reasons for calculated answers. Balint’s syndrome results from bilateral superior-parietooccipital damage (disruption to the dorsal ‘‘where” stream linking visual and parietal association areas). The triad of symptoms is shown in the attached figure. Possible causes include carbon monoxide poisoning, infarction, and Alzheimer’s disease. Gerstmann syndrome is characterized by four primary symptoms: dysgraphia/agraphia, dyscalculia/acalculia, finger agnosia and left-right disorientation. The full presentation of tetrad is rare but occurs with lesions in the dominant angular and supramarginal gyri (parietal lobe). Anton’s syndrome occurs in bilateral occipital damage. The patient denies any deficit and may even attempt to walk and navigate without success. Marchiafava-Bignami disease is due to symmetrical demyelination and necrosis of corpus callosum and adjacent anterior commissure. It is mostly seen in alcoholics using red wine excessively (not clear whether some impurities are implicated). Patients present with sudden onset of stupor or coma and seizures. A chronic onset of dementia and/or gait problems with spasticity is also reported.

•inability to attend to more than one item of a complex scene at a time simultanagnosia simultanagnosia •inability to guide reaching or pointing despite adequate vision optic ataxia optic ataxia •inability to voluntarily direct saccades to a visual target oculomotor apraxia oculomotor apraxia