Transient topographical amnesia and cingulate cortex damage: A case report
Transient topographical amnesia and cingulate cortex damage: A case report
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DOI：
10.1016/0028-3932(95)00108-5
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发表时间：
1996-04-01
期刊：
影响因子：
2.6
通讯作者：
Camarda, R
中科院分区：
文献类型：
--
作者：
Camalleri, R;Gangitano, M;Camarda, R
暂时性地形遗忘症（TTA）是由于无法使用熟悉的环境地标进行路线寻找而导致暂时无法在熟悉或不熟悉的环境中找到自己的路。该综合征尚未被描述为具有任何明显的病因，并且被认为是由对地形识别至关重要的右半球结构（即顶叶联合和海马旁皮质）中的血管缺陷引起的。本研究中描述的患者主诉有几次严重的TTA发作和左侧肢体强直性强直。神经心理学评估是正常的，除了在空间记忆任务的赤字。脑部磁共振成像显示右侧扣带回皮质24 d和23区边缘有一个血管瘤。由于23区是战略性地位于一个网络，连接顶叶联合（区7a）和海马旁皮质，因为这些皮质区参与地形定向过程，我们认为，一个短暂的功能失活的网络所造成的癫痫放电从受损的扣带回皮质扩散到海马旁和顶叶联合皮质可以解释的空间障碍。从24 d区向初级运动皮层和/或脊髓传播的类似放电可以解释左侧肢体强直性强直发作。
Transient topographical amnesia (TTA) is the temporary inability to find one's way in familiar or unfamiliar surroundings due to the inability to use well known environmental landmarks for route finding. The syndrome has not been described as having any obvious aetiology and has been thought to be caused by a vascular deficit in right hemispheric structures which are crucial for topographic recognition, i.e. parietal association and parahippocampal cortex. The patient described in the present study complained of several critical episodes of TTA and tonic rigidity of the left limbs. Neuropsychological assessment was normal except for a deficit in spatial memory tasks. Magnetic resonance (MR) imaging of the brain showed an angioma at the border of areas 24d and 23 of the right cingulate cortex. Because area 23 is strategically located in a network that links the parietal associative (area 7a) and parahippocampal cortices, and because these cortical areas are involved in topographical orienting processes, we suggest that a transient functional inactivation of the network caused by epileptic discharges spreading from the damaged cingulate cortex towards the parahippocampal and parietal association cortex could account for the spatial disorder. Similar discharges spreading from area 24d towards the primary motor cortex and/or the spinal cord could account for the episodes of tonic rigidity of the left limbs.