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Stroke
Published in Henry J. Woodford, Essential Geriatrics, 2022
A speech disorder may be identified while taking the patient's history. When testing for speech problems it is important to ensure that the patient has the best chance of responding appropriately, for example, their hearing aid is fitted and working. Asking the patient to obey commands tests comprehension of speech (i.e. to identify receptive problems). These should initially be one-stage commands (e.g. ‘close your eyes'), but then can be more complex sequences (e.g. ‘point to the door, the window and then the ceiling'). Problems with speech expression can be detected by asking the patient to name objects (e.g. pen and watch, then the smaller components of each, such as the nib and hands). Subtle dysarthria may be detected by asking the patient to repeat difficult phrases, for example ‘West Register Street', ‘baby hippopotamus' and ‘biblical criticism'. Agnosia is a high-level sensory disturbance that leads to a failure to recognise objects despite intact sensory systems. People with aphasia can usually mime how an object is used (e.g. a pen) even if they cannot name it, whereas those with agnosia cannot.
Psychosocial Aspects of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
The signs and symptoms of dementia develop slowly, usually beginning with loss of short-term memory and sometimes other cognitive abilities as well, such as language, attention, and executive functioning. Symptoms are divided into early, intermediate, and late classifications. Personality changes and altered behaviors can develop early or late in the progression of dementia. Based on the type of dementia, motor and other focal neurologic deficits occur at different stages. In vascular dementia, these occur early, while in AD, they develop late. Early symptoms of dementia include short-term memory impairment, with the learning and retaining of new information becoming difficult. The patient will have difficulty finding the right word when speaking, and experience mood swings and personality changes. It may become harder to handle daily living tasks such as remembering where objects were placed, handling banking activities, remembering to take medications, and even getting lost in a familiar location. There may be impairment of abstract though, judgment, or insight. The patient often becomes agitated, hostile, and irritable because of these changes. Other manifestations include agnosia, apraxia, and aphasia. Agnosia is impairment of identifying objects while sensory function is normal. Apraxia is impairment in performing learned motor activities while motor function is still intact. Aphasia is impairment of language use or comprehension. Family members of dementia patients often report odd behaviors along with emotional changes.
Signs and Symptoms in Psychiatry
Published in Mohamed Ahmed Abd El-Hay, Essentials of Psychiatric Assessment, 2018
Agnosia is a failure of recognition through a sensory modality of a previously known stimulus, although there is no perceptual disorder of the sensory modality and the patient is alert and cooperative (Table 2.4).
The neuropsychological rehabilitation of visual agnosia and Balint’s syndrome
Published in Neuropsychological Rehabilitation, 2019
Joost Heutink, Dana L. Indorf, Christina Cordes
According to Zihl (2003), visual agnosia is a difficulty or inability to identify familiar stimuli via the visual modality, although the patient possesses sufficient visual perceptual, cognitive, and verbal functioning, and is able to recognise the stimulus using other modalities. Pure visual agnosia is a relatively rare condition, with an estimated prevalence of about 1–3% (Zihl & Kennard, 2003). At least four types of visual agnosia can be differentiated: prosopagnosia (the inability to recognise familiar faces and to learn new faces); object agnosia (the inability to identify stimuli in the same class or differentiate between classes of stimuli); topographical agnosia (difficulties with geographical orientation); and letter agnosia or pure alexia (inability to recognise individual letters and their combinations; Damasio, Tranel, & Rizzo, 2000; Roberts, 1992; Zihl, 2003). However, also finer distinctions can be made and very specific agnosias can be found in the literature as well (e.g., colour agnosia; Nijboer & Heutink, 2017).
Central deafness: a review of past and current perspectives
Published in International Journal of Audiology, 2019
Frank E. Musiek, Gail D. Chermak, Barbara Cone
Auditory agnosia has been subtyped as a function of the type of sounds unrecognised by the patient. Selective auditory agnosias have been distinguished by the specific categories of sound for which recognition is impaired. While the term nonverbal agnosia (NVA) appears in the literature referring to a patient’s inability to recognise or identify nonverbal (environmental) sounds, noise or music despite adequate pure-tone sensitivity, while retaining the ability to read, write, name objects and speak spontaneously/converse, pure NVA in the absence of any verbal comprehension component is a rare condition, with only eight published cases through 2000 (Bauer 2006; Habib et al. 1995; Taniwaki et al. 2000). Agnosia for both nonverbal and verbal acoustic stimuli might be more appropriately considered under the umbrella of CD. As discussed below, we consider verbal agnosia and word deafness to be two labels describing quite similar conditions.
Neuro-Ophthalmic Literature Review
Published in Neuro-Ophthalmology, 2019
David Bellows, Noel Chan, John Chen, Hui-Chen Cheng, Panitha Jindahra, Rauan Kaiyrzhanov, Peter MacIntosh, Michael Vaphiades, Konrad P. Weber, Sui Wong
This paper attempts to outline the current concepts of anatomy and neurophysiology underlying selective disorders of higher visual processing, i.e. the visual agnosias, and to describe the clinical conditions themselves. Every new case of agnosia has the potential to provide greater insight into the way the brain processes vision, as reflected in the ever-increasing number of related publications in the fields of visual physiology, neuropsychology, and neuroimaging. There is currently little that can be offered by way of treatment for most cases of visual agnosia, but an increase in our understanding has the potential to change this. Owing to the limitations of space, several disorders simply could not be covered, including congenital prosopagnosia, blindsight, hemispatial neglect, various forms of specific anomia and amnesia, and the different types of alexia. Given our aging population, these disorders will become more common and are more likely to be detected if they are specifically looked for, particularly in the context of stroke and degenerative disease. If physicians are familiar with the visual agnosias then their existence in patients will be more readily detected.