| Identifier |
Simultagnosia |
| Title |
Simultagnosia |
| Creator |
Andrew G. Lee, MD; Jared Alexander |
| Affiliation |
(AGL) Chairman, Department of Ophthalmology, The Methodist Hospital, Houston, Texas; Professor of Ophthalmology, Weill Cornell Medicine, New York City, New York; (JA) Class of 2021, Baylor College of Medicine, Houston, Texas |
| Subject |
Simultagnosia; Simultanagnosia; Ophthalmology |
| Description |
Dr. Lee lectures medical students on simultagnosia. |
| Transcript |
Today we're going to be talking about simultagnosia or simultanagnosia, and basically it's "nosia, which is "know," but we are "agnosia," "don't know" and "simultaneous" which is two stimuli presented at the same time. So when you have simultagnosia or simultanagnosia you don't know simultaneous stimuli. And so patients with that complaint often say they can see the individual pieces of a visual image, but they can't put it together. So they can see the trees, but they can't see the forest. So one of the standardized ways we test this is with this standardized cookie theft picture. And so a patient who has simultanagnosia or simultagnosia will see the girl and the boy in the chair but they won't be able to put together the picture. They'll see the water is running down. So we ask them what's going on with this picture and they will be able to individually identify each of the pieces, but they won't be able to make a cohesive story out of it. So this is a standardized simultanagnosia test. And one of the interesting things is we use the Ishihara color plates, which is usually used to test for color vision deficit, but just like the cookie theft picture, in the patient who has simultagnosia, they can see the individual dots but they can't see that the dots actually make up a number. Even though they can see the colors. So they might get zero out of 14 on the color plates even though they have 20/20 acuity and a normal exam. So we can use the Ishihara color plates as a test for simultagnosia, and that is a very fascinating way to use that color plate. The way this comes to us is patients have seen multiple eye doctors, they have normal vision, they have a normal eye exam, pupil, everything is normal. But they're still having this persistent complaint that they can see, but they can't process the information. And so a patient with this condition might be able to identify each of these geometric figures individually. So if we were to separate them out they would be able to tell what they are, but once we start stacking them up on top of each other they won't be able to interpret the image, they will get confused. And so this is a visual processing problem. The processing problem can occur in the visual association cortex, adjacent parietal lobe. They may or may not have a homonymous hemianopsia or neglect. And if you have bilateral lesions it might be associated with optic ataxia, and what that means is they mislocalize in space or ocular motor apraxia where they can't move their eyes with supranuclear gaze towards objects, and simultagnosia - that constellation of findings is called the Balint's syndrome. So you should know that if you have simultaneous agnosia, cookie theft picture, Ishihara color plate, the complaints are quite vague, but they have normal eye exams and they can see the individual pieces but they can't see the forest for the trees. |
| Date |
2020-05-27 |
| Language |
eng |
| Format |
video/mp4 |
| Type |
Image/MovingImage |
| Collection |
Neuro-Ophthalmology Virtual Education Library: Andrew G. Lee Collection: https://novel.utah.edu/Lee/ |
| Publisher |
North American Neuro-Ophthalmology Society |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Rights Management |
Copyright 2019. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s63r66xw |
| Setname |
ehsl_novel_lee |
| ID |
1561530 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s63r66xw |
