Autotopagnosia

Following a vascular lesion in the parietal cortex of the language dominant hemisphere (right in one case), two patients showed a striking dissociation between spared naming, recognition and use of their body parts and an inability in localising on verbal command the same body parts on themselves and on a mannequin (Autotopagnosia, AT). The patients were submitted to a modified version of Reed and Farah Test (1995), a test that taps the ability to encode changes of body position as opposed to changes of position of objects...

We describe a disorder similar to body-image agnosia or autotopagnosia characterized by the inability to designate targets situated outside the body. This disorder, which we have termed allotopagnosia, occurs exclusively in subjects with a lesion involving the posterior region of the left parietal lobe. The most common manifestation is the designation of parts of the body of another person as being part of the patient's own body (heterotopagnosia with self-designation). This disorder cannot be explained by aphasia, apraxia, or visuomotor dysfunction nor by an inability to identify parts of the body as self...

A 52-year-old right-handed man presented progressive dystonia and apraxia of his right hand of five years' duration. He also suffered from parkinsonian features such as rigidity or impaired postural reflexes. Serial investigation of brain MRI revealed progressive cerebral atrophy, which started in the left parietal lobe, and subsequently extended to both hemispheres. He was clinically diagnosed as corticobasal degeneration. He could not point at any part of his own body in response to verbal or visual commands...

The authors report the case of a 42 years-old electrician man, with an 8 months progressive manual difficulties in his specific job, with a complete disability for the last 2 months. These symptoms were associated with anemia, deterioration of the general condition, and slight fever. Three days after the first neuropsychological examination he, suddenly, developed a left hemiparesis. Laboratory investigations confirmed the occurrence of a systemic lupus erythematosus. The neuropsychological examination showed: normal intellectual level with slight memory deficit; severe constructional and ideomotor apraxia; gaze ataxia; optical ataxia; hemisomatoagnosia, anosognosia, and autotopagnosia; agraphia...

A 72-year-old right-handed hypertensive man presented with a right brachial monoplegia, and hypesthesia of the right half of the body to touch and pricking, sparing the face. A CT scan 2 weeks later showed a spontaneous hyperdense area corresponding to a left subcortical parietal hematoma. The patient used his spontaneous language to express body image disturbances: intense prolonged feeling of amputation related to the upper limb and foot on the right side, hemiasomatognosia without anosognosia, autotopagnosia...

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A patient with a metastasis in the left parietal lobe demonstrated difficulty in pointing to body parts although he could name them when they were pointed to by someone else. As he had no nominal aphasia, could understand complex verbal instructions and could correctly describe the functions of named body parts, his autotopagnosia is unlikely to be a result of a category-specific comprehension deficit. As he is able to point to parts of objects, plants and animals on command, his disorder is also unlikely to be part of a general inability to analyse a whole into its details...

Body schema disturbances were studied in a 62-yr-old woman with Alzheimer's disease. She was severely impaired in verbal and nonverbal tasks requiring her to localize body parts (on her own body, the examiner's body or a doll's body) even though she correctly named the same parts when pointed at by the examiner. Pointing responses were misdirected mainly to parts contiguous with the target area and, to a lesser extent, to functionally equivalent body parts. We also found that the patient was able to define body part names functionally but not spatially...

One hundred and twenty patients with unilateral cerebral hemisphere damage (54 aphasics, 21 non-aphasic left and 45 right brain-damaged patients and 57 control subjects without cerebral lesions were given a battery of verbal and non-verbal tests of autotopagnosia, with the aim of studying the relationships between disorders of body schema and the side of the hemispheric lesion. A second aspect of our research consisted in understanding whether impairment in naming and pointing to body parts following verbal commands was really a specific symptom or if the same difficulty was found when patients were asked to name or to point to parts of objects other than the human body...