Document Detail


Posterior cortical dementia with alexia: neurobehavioural, MRI, and PET findings.
MedLine Citation:
PMID:  1865209     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A progressive disorder of relatively focal but asymmetric biposterior dysfunction is described in a 54 year old right handed male. Initial clinical features included letter-by-letter alexia, visual anomia, acalculia, mild agraphia, constructional apraxia, and visuospatial compromise. Serial testing demonstrated relentless deterioration with additional development of transcortical sensory aphasia, Gerstmann's tetrad, and severe visuoperceptual impairment. Amnesia was not an early clinical feature. Judgment, personality, insight, and awareness remained preserved throughout most of the clinical course. Extinction in the right visual field to bilateral stimulation was the sole neurological abnormality. Early CT was normal and late MRI showed asymmetrical bioccipitoparietal atrophy with greater involvement of the left hemisphere. Results from positron emission tomography (PET) showed bilaterally asymmetric (left greater than right) occipitotemporoparietal hypometabolism. The metabolic decrement was strikingly asymmetric with a 50% reduction in glucose consumption confined to the left occipital cortex. The picture of occipitotemporoparietal compromise verified by MRI, PET, and neurobehavioural testing would be unusual for such degenerative dementias as Alzheimer's (AD) and Pick's disease, although atypical AD with predominant occipital lobe involvement cannot be excluded. This case supports the concepts of posterior cortical dementia (PCD) as a clinically distinct entity and for the first time documents its corresponding metabolic deficit using PET.
Authors:
L Freedman; D H Selchen; S E Black; R Kaplan; E S Garnett; C Nahmias
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurology, neurosurgery, and psychiatry     Volume:  54     ISSN:  0022-3050     ISO Abbreviation:  J. Neurol. Neurosurg. Psychiatr.     Publication Date:  1991 May 
Date Detail:
Created Date:  1991-09-09     Completed Date:  1991-09-09     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  2985191R     Medline TA:  J Neurol Neurosurg Psychiatry     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  443-8     Citation Subset:  IM    
Affiliation:
Department of Psychology, Mississauga Hospital, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Atrophy
Brain / metabolism,  pathology,  radionuclide imaging
Dementia / diagnosis*,  metabolism,  radionuclide imaging
Dyslexia, Acquired / diagnosis*,  metabolism,  radionuclide imaging
Humans
Magnetic Resonance Imaging*
Male
Middle Aged
Neuropsychological Tests
Occipital Lobe / metabolism,  pathology*,  radionuclide imaging
Parietal Lobe / metabolism,  pathology,  radionuclide imaging
Tomography, Emission-Computed*
Comments/Corrections

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