Hirayama K, Taguchi Y, Sato M, Tsukamoto T
Division of Neuropsychology, Department of Disability Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.
J Neurol Neurosurg Psychiatry. 2003 Jan;74(1):110-2. doi: 10.1136/jnnp.74.1.110.
A case of paraneoplastic limbic encephalitis presenting with topographical disorientation is reported. A 70 year old woman became unable to identify familiar buildings and landscapes and could not recall the way to destinations she had known very well for years. She also showed attentional disturbance and severe anterograde amnesia. Her retrograde amnesia extended for one year at most. No other neuropsychological deficits were noted. Thus her topographical disorientation was of the primary form. Specific tests related to topographical disorientation showed that her two main symptoms seem to fall into the categories of landscape agnosia and heading disorientation. T2 weighted magnetic resonance imaging revealed high intensity signals in the anteromedial temporal lobes bilaterally, in the right posterior parahippocampal gyrus, in the right retrosplenial region, and in the right inferior precuneus. Anti-Hu antibody was found in the serum. This case shows that topographical disorientation can be a primary symptom of limbic encephalitis.
报告了一例以地形定向障碍为表现的副肿瘤性边缘叶脑炎病例。一名70岁女性无法识别熟悉的建筑物和景观，也想不起多年来熟知的前往目的地的路线。她还表现出注意力障碍和严重的顺行性遗忘。她的逆行性遗忘最多延伸至一年。未发现其他神经心理学缺陷。因此，她的地形定向障碍属于原发性形式。与地形定向障碍相关的特定测试表明，她的两个主要症状似乎属于景观失认症和方向迷失类别。T2加权磁共振成像显示双侧前内侧颞叶、右侧海马旁回后部、右侧压后皮质区域及右侧楔前叶下部有高强度信号。血清中发现抗Hu抗体。该病例表明，地形定向障碍可能是边缘叶脑炎的主要症状。
