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Visuo‐spatial dysgnosia and Balint's syndrome as major symptoms of probable Alzheimer's disease
Author(s) -
Davous P.,
Panisset M.,
Agostini M.,
Boiler F.
Publication year - 1996
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.1996.tb00267.x
Subject(s) - posterior cortical atrophy , medicine , dementia , atrophy , apraxia , disease , alzheimer's disease , ataxia , audiology , pediatrics , pathology , psychiatry , aphasia
We describe three patients, respectively 57‐, 54‐ and 55‐years‐old at onset of the disease, who developed over many years a progressive cortical visual dysfunction without overt dementia. At onset, the visual symptoms were mainly a visuo‐spatial dysgnosia, but they progressively worsened to a near complete Balint syndrome in the three cases. In all of them, memory and language were only mildly affected during the first years of evolution, but a constructive and/or dressing apraxia and an optic ataxia in the left visual hemifield suggested in two cases a predominant dysfunction in the right hemisphere. Imaging of the brain by CT scan and MRI showed no focal atrophy, but the metabolic SPECT was early abnormal in all three cases showing a right posterior metabolic defect in two cases and a bilateral posterior hypometabolism in one case. Follow‐up of the patients showed that they all developed language and memory disturbances leading to severe dementia after 5–8 years of evolution. It is suggested that these patients are affected by a visual form of Alzheimer's disease which is probably the most frequent cause of progressive Balint‐Holmes syndrome.