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As we approach the centennial of Alois Alzheimer’s seminal contributions to neurology, our patients remind us that we often lose track of his important observations. Alzheimer described a diverse syndrome with a prominent memory disorder and a variety of cortical findings. In this issue of Neurology, Renner et al.1 and Tang-Wai et al.2 shed new light on the syndrome of posterior cortical dementia, first described in the 1980s as a visuospatial harbinger of Alzheimer disease (AD).3,4⇓
Both groups report a syndrome of posterior cortical deficits in patients who are somewhat younger than most demented persons. Renner et al. describe 27 patients (mean age 66 years) who presented with visuospatial signs and symptoms that were at least as prominent as memory impairment. The most common visuospatial disturbances included elements of Balint’s syndrome (ocular apraxia, optic ataxia, simultagnosia) and Gerstmann’s syndrome (acalculia, agraphia, finger agnosia, right-left confusion). Posterior cortical neighborhood findings included language impairments, especially subtle non-fluency, and apraxia, especially of the ideomotor variety.
Tang-Wai et al. describe 40 patients (mean age = 60) who presented with elements of Balint’s syndrome, especially simultagnosia, or of Gerstmann’s syndrome, especially acalculia. Visual field defects were common, as were ideomotor apraxia and anomia. Notably, memory and insight …
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