Simultanagnosia as the initial sign of degenerative dementia

Neill R Graff Radford, J. P. Bolling, F. Earnest IV, E. A. Shuster, Richard John Caselli, P. W. Brazis

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

In a study of 10 patients with degenerative brain disease that manifested as simultanagnosia, our aims were (1) to elucidate their clinical, neuropsychologic, and radiologic findings to determine whether these patients might represent a group distinguishable from those with typical Alzheimer's disease and (2) to help clinicians recognize this entity. All patients were initially examined by ophthalmologists because of visual difficulties, and the simultanagnosia remained undiagnosed until nonophthalmologic complaints developed. Optic ataxia developed in six patients, and all patients had mildly impaired eye movements. All 10 patients could identify colors appropriately. Nine patients had language deficits (anomia, decreased auditory comprehension, alexia, and agraphia) but were fluent and had relative preservation of sentence repetition, and four performed in the normal range on a test of associative fluency. Two patients scored in the normal range on memory tests, all had preserved insight, and nine had no family history of degenerative dementia. The mean age at onset of the disorder was 60 years (range, 50 to 69). Neuroimaging disclosed prominent bilateral occipitoparietal atrophy in nine patients and generalized atrophy in one. With this unusual but consistent clinical, neuropsychologic, and anatomic profile, these patients are clinically distinguishable from those with typical Alzheimer's disease, but until a specific cause has been found, we cannot be certain that they constitute a specific biologic entity. Clinicians should consider this diagnosis in relatively young patients who have slowly progressive nonocular visual complaints.

Original languageEnglish (US)
Pages (from-to)955-964
Number of pages10
JournalMayo Clinic Proceedings
Volume68
Issue number10
StatePublished - 1993

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Dementia
Atrophy
Reference Values
Anomia
Agraphia
Dyslexia
Brain Diseases
Ataxia
Eye Movements
Age of Onset
Neuroimaging
Alzheimer Disease
Language
Color

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Graff Radford, N. R., Bolling, J. P., Earnest IV, F., Shuster, E. A., Caselli, R. J., & Brazis, P. W. (1993). Simultanagnosia as the initial sign of degenerative dementia. Mayo Clinic Proceedings, 68(10), 955-964.

Simultanagnosia as the initial sign of degenerative dementia. / Graff Radford, Neill R; Bolling, J. P.; Earnest IV, F.; Shuster, E. A.; Caselli, Richard John; Brazis, P. W.

In: Mayo Clinic Proceedings, Vol. 68, No. 10, 1993, p. 955-964.

Research output: Contribution to journalArticle

Graff Radford, NR, Bolling, JP, Earnest IV, F, Shuster, EA, Caselli, RJ & Brazis, PW 1993, 'Simultanagnosia as the initial sign of degenerative dementia', Mayo Clinic Proceedings, vol. 68, no. 10, pp. 955-964.
Graff Radford NR, Bolling JP, Earnest IV F, Shuster EA, Caselli RJ, Brazis PW. Simultanagnosia as the initial sign of degenerative dementia. Mayo Clinic Proceedings. 1993;68(10):955-964.
Graff Radford, Neill R ; Bolling, J. P. ; Earnest IV, F. ; Shuster, E. A. ; Caselli, Richard John ; Brazis, P. W. / Simultanagnosia as the initial sign of degenerative dementia. In: Mayo Clinic Proceedings. 1993 ; Vol. 68, No. 10. pp. 955-964.
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