Prosopagnosia After Stroke: Potentials for Impairment and Treatment

Abstract

The ability to recognize and identify people and determine how they may be feeling from looking at their faces is an important skill that people normally achieve effortlessly in infancy. Effective face recognition skills remain essential for social competence throughout the life course. A major cause of impairment in face processing, conventionally known as prosopagnosia, is stroke. In this article, the potentials for acquired prosopagnosia after stroke are examined. The incidence of prosopagnosia after stroke is difficult to establish, but in one clinical sample about half of those who survived a right hemisphere stroke had prosopagnosia. The recently published National Clinical Guideline for Stroke 2012 omits reference to assessment for prosopagnosia, which suggests that the personal distress and negative impact on social life that can accompany prosopagnosia is not fully appreciated or at least not considered a priority after stroke. The few published cases where there has been a focused attempt to provide rehabilitation for chronic prosopagnosia suggest that lesions in face-processing areas are resistant to treatment but that some recovery can accompany extended practice. It is concluded that where there is evidence of prosopagnosia following stroke, treatment should be offered, although rehabilitation may be better focused on supporting and extending existing compensatory strategies, such as the use of voice, body shape, and gait to assist in person recognition and, as an important consequence, social functioning.