Croisile B, Trillet M, Hibert O, Cinotti L, Le Bars D, Mauguière F, Aimard G
Service de Neurologie, Hôpital Neurologique, Lyon.
Rev Neurol (Paris). 1991;147(2):138-43.
A 57 year-old woman developed a slowly progressive environmental agnosia and dressing apraxia without disturbances of language, memory, orientation and social activities. Two years later, alexia, agraphia, visual agnosia, constructional apraxia, simultagnosia and imitation apraxia of nonsymbolic gestures were also noted. Ophthalmic examination demonstrated a left inferior quadranopsia. Oral comprehension was normal. There was no loss of insight, and behavioral response was appropriately concerned. Computed tomography and magnetic resonance imaging revealed bilateral cortical atrophy in parieto-occipital areas, most pronounced on the right side, with enlargement of the ventricles. Positron emission tomography demonstrated low flow and metabolism values in the right parietal, temporal and occipital regions. This case is very similar to those of posterior cortical atrophy recently reported by Benson et al. (1988). It suggests a selectively degenerative dysfunction of posterior association cortex, sparing oral language and verbal memory.
一名57岁女性出现了逐渐进展的环境失认症和穿衣失用症，语言、记忆、定向和社交活动均无障碍。两年后，还出现了失读症、失写症、视觉失认症、结构失用症、同时失认症以及非符号性手势的模仿失用症。眼科检查显示左眼下方象限盲。口语理解正常。自知力未丧失，行为反应恰当。计算机断层扫描和磁共振成像显示双侧顶枕叶皮质萎缩，右侧最为明显，脑室扩大。正电子发射断层扫描显示右侧顶叶、颞叶和枕叶区域血流和代谢值降低。该病例与本森等人（1988年）最近报道的后皮质萎缩病例非常相似。这提示后联合皮质存在选择性退行性功能障碍，而口语和言语记忆未受影响。
