Anton's Syndrome

Presentation higher cortical visual disorders, by subject.

Higher Order Cortical Visual Disorders: A Case-Based Approach Sashank Prasad, MD Professor of Clinical Neurology University of Pennsylvania Perelman School of Medicine Marc Dinkin, MD Associate Professor of Neurology Associate Professor of Ophthalmology New York-Presbyterian Hospital Weill Cornell Medicine Course Director Outline • Anton’s syndrome • Central hemi-achromatopsia • Apperceptive agnosia • Alexia without agraphia • Riddoch syndrome • Prosopagnosia • Balint’s syndrome • Lhermitte’s peduncular hallucinosis • Capgras syndrome • Charles Bonnet syndrome Outline • Anton’s syndrome • Central hemi-achromatopsia • Apperceptive agnosia • Alexia without agraphia • Riddoch syndrome • Prosopagnosia • Balint’s syndrome • Lhermitte’s peduncular hallucinosis • Capgras syndrome • Charles Bonnet syndrome Cortical Visual Areas Dorsal Stream (Where) V6/DM PPC V3d V2d Posterior parietal cortex Frontal cortex: Awareness of vision Identify errors MT/ V5 V1 V2v IT V4 R or L V3v Ventral Stream (What) Outline • Anton’s syndrome • Central hemi-achromatopsia • Apperceptive agnosia • Alexia without agraphia • Riddoch syndrome • Prosopagnosia • Balint’s syndrome • Lhermitte’s peduncular hallucinosis • Capgras syndrome • Charles Bonnet syndrome Anton’s syndrome 48-year-old man found to have severe visual impairments and new atrial fibrillation Anton’s syndrome 48-year-old man found to have severe visual impairments and new atrial fibrillation Anton’s syndrome From the Clinic for Nervous and Mental patients in Graz On the Self-awareness of Neurologic Deficits in Patients with Cortical Blindness and Cortical Deafness by Prof. G. Anton in Graz. 50 50 Ursula Mercz, a 56-year-old needlewoman, was treated in Graz Hospital for Nervous Diseases from November 30th 1894 until May 29th 1895. Her condition was characterized by complete blindness although the pupils and fundi remained normal. The patient could not distinguish light and darkness. She could not perceive objects, either when close to or distant from her. Even a sudden approach or quick intensive illumination did not elicit a reaction. Her gaze stared into empty space; fixation could not be confirmed. It was very striking that the patient did not take any notice of her complete loss of vision. The patient, who otherwise complained a lot, was almost unaffected by the visual deficit. Anton’s syndrome From the Clinic for Nervous and Mental patients in Graz On the Self-awareness of Neurologic Deficits in Patients with Cortical Blindness and Cortical Deafness by Prof. G. Anton in Graz. Post-mortem. Examination of the brain did not show generalized atrophy. There was cystic necrosis primarily affecting the gray and white matter of the right and left occipital lobes. This condition may represent a breakdown of the functional relationships between cortical areas. It is undoubtedly possible that the function of some parts of the brain, which are not damaged themselves, can become altered through damage to other parts. • WHAT pathway is missing input • Awareness of lack of visual input, as processed by the frontal cortex, is faulty Anton’s Syndrome