Martory M D, Mayer E, Pegna A J, Annoni J M, Landis T, Khateb A
Neuropsychology Unit, Department of Neurology, University Hospital, Geneva, Switzerland.
Neurocase. 2003 Aug;9(4):319-28. doi: 10.1076/neur.9.4.319.15549.
We describe the case of a right-handed patient who presented a severe acalculia in the context of a pure Gerstmann syndrome following a subangular lesion that spared the left inferior parietal lobule (IPL). The patient showed impairments in Arabic and verbal codes, in number production and comprehension, as well as in numerical facts and problem solving. By using the EC301 calculation battery, semantic and syntactic tasks in Arabic and verbal codes, we tested the different hypotheses raised by the cognitive neuropsychological models of acalculia. The patients' difficulties, which were not associated with a general intellectual deterioration, and those affecting number processing as a particular semantic class, were indicative of a "global acalculia". This deficit, which exceeded the anarithmetia usually described in Gerstmann syndrome following left IPL lesion, suggested that the isolation of this area may constitute a sufficient condition for producing such a global acalculia. These results are discussed in terms of a disorder in the manipulation of mental images of spatially related objects.
我们描述了一名右利手患者的病例，该患者在左侧角回下方病变但未累及左下顶叶小叶（IPL）的情况下，出现了纯格斯特曼综合征背景下的严重失算症。患者在阿拉伯数字和语言编码、数字生成与理解以及数字事实和问题解决方面均表现出障碍。通过使用EC301计算测试组、阿拉伯语和语言编码中的语义和句法任务，我们检验了失算症认知神经心理学模型提出的不同假设。患者的困难并非与一般智力衰退相关，且那些影响作为特定语义类别的数字处理的困难，表明存在“整体性失算症”。这种缺陷超过了左侧IPL病变后格斯特曼综合征中通常描述的失算术，提示该区域的孤立可能是产生这种整体性失算症的充分条件。这些结果将根据空间相关物体心理意象操作障碍进行讨论。
