Abstract
<strong>Background:</strong> Posterior cortical atrophy is a clinical syndrome that is characterized by the progressive loss of visuospatial integration and is associated with neurodegenerative conditions. <strong>Case Report:</strong> We describe a 60-year-old female with simultanagnosia, oculomotor apraxia, and optic ataxia for which she received an initial clinical diagnosis of posterior cortical atrophy. Three years later, she developed Balint’s syndrome, Gerstmann’s syndrome, left alien hand syndrome, smooth asymmetric (left) rigidity, cortical sensory loss, and spontaneous myoclonic jerks of the left arm, which suggested a final diagnosis of corticobasal syndrome. <strong>Discussion:</strong> This case report indicates that corticobasal syndrome may present with visuospatial deficits.
Highlights
Posterior cortical atrophy (PCA) is a neurodegenerative syndrome that is characterized by the progressive decline of multiple cognitive functions, such as visuoperceptual and visuospatial skills, and arises from the dysfunction of parieto-occipital regions.[1]
Physical examination does not reveal signs of dysfunction in other systems of the central nervous system, the occurrences of extrapyramidal signs, myoclonus, and grasp reflex are reported in most cases of PCA; these symptoms occur with prevalences similar to those observed in typical Alzheimer’s disease (AD).[3]
Several clinical syndromes can be caused by different underlying neuropathologies
Summary
Posterior cortical atrophy (PCA) is a neurodegenerative syndrome that is characterized by the progressive decline of multiple cognitive functions, such as visuoperceptual and visuospatial skills, and arises from the dysfunction of parieto-occipital regions.[1] Age at onset is typically between 50 and 65 years, and patients usually first present to ophthalmologists with difficulties in fine vision tasks distinguishing lines and reading texts, judging distances, identifying static objects within the visual field, or problems with stairs and escalators.[2] After ophthalmologic consultation, and sometimes after receiving unnecessary medical procedures, such as cataract surgery, patients are sometimes referred to psychiatrists for evaluations for depression, anxiety, or malingering, which are frequently thought to be responsible for the complaints. The symptoms typically progress over a brief time span, and careful neuropsychological evaluation often reveals signs of cognitive decline that are related to visuospatial abilities and include ideational and ideomotor apraxia, dyscalculia, problems with spelling, and memory deficits. Cases of CBS that present with a complex visuospatial disorder, such as Balint’s syndrome (simultanagnosia, optic ataxia, oculomotor apraxia), that is present from early onset have been reported.[5,6] In this report, we describe a case of PCA that developed to CBS over a span of 3 years
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