Abstract
Interhemispheric disconnection syndrome (IDS), described by Sperry, Gazzaniga and Bogen, is characterized by the presence of visual and tactile anomia, absence of interhemispheric transference of unilateral somatosensory stimulation of both hands, hemialexia and unilateral left-side apraxia. Subsequently, changes were also observed in the sensory interhemispheric transfer and in tests of crossed motor control. In Marchiafava-Bignami disease (MBD) there have been descriptions of partial IDS. The aim is to describe the dissociations in IDS that are presented in a patient with MBD, using a specialized assessment methodology. Patient and Method: A 54-year-old patient, righthanded, with 11 years of schooling, presented with antecedent chronic alcoholism. Neuropsychological tests were administered for general assessment along with specific tests of interhemispheric transference. Results: Borderline changes were found in visual memory, visual-constructive abilities and attention and executive functioning. In tasks of interhemispheric transference the patient showed changes in: the imitation of hand poses; inter-manual pressure point localization (tactile stimulation); reading aloud of words by visual hemifield; and movement control. Conclusion: Our patient showed a wide lesion of the Corpus Callosum (CC) with relative preservation of the splenium, accompanied by partial disconnection syndrome in the context of a global cognitive deterioration from his chronic alcoholism.
Highlights
Interhemispheric disconnection syndrome (IDS) as a consequence of the sectioning of the Corpus Callosum (CC), described by Sperry, Gazzaniga and Bogen (1987), presents typical functioning in the domains of behavior, personality and intelligence, making it impossible to distinguish between individuals with IDS and healthy controlls [1]
Our patient showed a wide lesion of the Corpus Callosum (CC) with relative preservation of the splenium, accompanied by partial disconnection syndrome in the context of a global cognitive deterioration from his chronic alcoholism
Even so, specialized assessment can reveal that IDS is characterized by the presence of visual and tactile anomia caused by the disconnection of the right hemisphere from the language mechanisms that are dominantly localized in the left hemisphere, the absence of interhemispheric transference of unilateral somatosensory stimulation of both hands, unilateral left-side hemialexia and apraxia
Summary
Interhemispheric disconnection syndrome (IDS) as a consequence of the sectioning of the Corpus Callosum (CC), described by Sperry, Gazzaniga and Bogen (1987), presents typical functioning in the domains of behavior, personality and intelligence, making it impossible to distinguish between individuals with IDS and healthy controlls [1]. Marchiafava-Bignami disease (MBD) is a rare complication of chronic alcoholism that causes demyelination and necrosis of the CC [3]. In both its acute and sub-acute forms [4], the occurrence of altered consciousness, such as stupor, at the onset of the illness is associated with a worse prognosis and more severe disability. A presentation with no alteration of consciousness is associated with a more favorable prognosis and is characterized by an acute or sub-acute onset that includes cognitive changes, dysarthria, gait disorders and interhemispheric disconnection [5]. Unlike in patients with commissurotomy, partial IDS has been reported in patients with MBD who have extracallosal lesions as a consequence of chronic alcoholism (Wernicke-Korsakoff Syndrome or alcoholic encephalopathy) [5,6]
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