Development of a partial Balint's syndrome in a congenitally deaf patient presenting as pseudo-aphasia.
Development of a partial Balint's syndrome in a congenitally deaf patient presenting as pseudo-aphasia.
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先天性耳聋患者出现部分巴林特综合征，表现为假性失语症。
DOI：
10.1080/13854040802448718
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
Marchman,HolmesB
中科院分区：
文献类型：
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作者：
Drane,DanielL;Lee,GregoryP;Huthwaite,JustinS;Tirschwell,DavidL;Baudin,BrettC;Jurado,Miguel;Ghodke,Basavaraj;Marchman,HolmesB
我们报告了一位56岁的右利手先天性耳聋女性，她表现出部分巴林特综合征，伴有局限于右下视觉象限的积极视觉现象（例如，色带，短暂的未成形的幻视）。巴林特综合征的特点是一个三联症的视觉眼部症状，通常发生在双侧顶枕叶病变。这些症状包括无法感知视野中的同时事件（视觉失认症），无法用眼睛注视和跟随物体（视觉失用症），以及视觉引导下的目标指向障碍（视觉共济失调）。我们的病人表现出失认症，视共济失调，左视野忽视，和所有复杂的视觉空间任务的损害，但表现出正常的视力，完整的视野，和其他正常的神经认知功能。患者的视觉-眼部症状是在她参与右侧脑桥小卒中康复治疗时发现的。在CT扫描上偶然发现累及两个枕叶的白色物质改变，显示脑桥梗死。由于患者依赖手语和阅读能力进行交流，这些视觉感知限制阻碍了她与他人互动的能力，并出现失语症。我们讨论了评估具有显著沟通障碍的患者的技术挑战（例如，需要一种非标准化的方法，缺乏这类特殊人群的规范性数据），同时指出超越标准的神经心理学成套测验可以作出重大贡献。
We present a 56 year-old, right-handed, congenitally deaf female who exhibited a partial Balint's syndrome accompanied by positive visual phenomena restricted to her lower right visual quadrant (e.g., color band, transient unformed visual hallucinations). Balint's syndrome is characterized by a triad of visuo-ocular symptoms that typically occur following bilateral parieto-occipital lobe lesions. These symptoms include the inability to perceive simultaneous events in one's visual field (simultanagnosia), an inability to fixate and follow an object with one's eyes (optic apraxia), and an impairment of target pointing under visual guidance (optic ataxia). Our patient exhibited simultanagnosia, optic ataxia, left visual field neglect, and impairment of all complex visual-spatial tasks, yet demonstrated normal visual acuity, intact visual fields, and an otherwise normal neurocognitive profile. The patient's visuo-ocular symptoms were noticed while she was participating in rehabilitation for a small right pontine stroke. White matter changes involving both occipital lobes had been incidentally noted on the CT scan revealing the pontine infarction. As the patient relied on sign language and reading ability for communication, these visuo-perceptual limitations hindered her ability to interact with others and gave the appearance of aphasia. We discuss the technical challenges of assessing a patient with significant barriers to communication (e.g., the need for a non-standardized approach, a lack of normative data for such special populations), while pointing out the substantial contributions that can be made by going beyond the standard neuropsychological test batteries.