Visual Agnosia Mimicking Memory Impairment: A Case Report of Posterior Cortical Atrophy

ABSTRACT

Vision specialists will benefit from increased awareness of posterior cortical atrophy (PCA) syndrome. Failure to adequately identify the chief complaint as a visual symptom may lead to incorrect diagnosis or diagnostic delay. A previously healthy, 59-year-old woman presented with a 5-year history of ‘losing her stuff’. Upon psychiatric and neuro-ophthalmological evaluation, this symptom was better recognised as a feature of visual agnosia and simultanagnosia. She also presented with multiple previously unrecognised symptoms indicative of higher visual processing dysfunction, such as alexia without agraphia, ocular motor apraxia, optic ataxia, prosopagnosia, akinetopsia and topographagnosia, so further assessment to investigate for PCA was carried out. After a work-up including cognitive assessment, brain structural/functional imaging, and laboratory tests she was diagnosed with visual-variant Alzheimer’s disease. Patients with PCA merit a detailed review of their symptoms, as well as the use of office tests such as cognitive evaluation tools, different types of perimetry, colour vision tests, and non-delayed psychiatric consultation for correct management and assessment. This report will emphasise five key aspects to be considered when evaluating patients with PCA

KEYWORDS:

• Posterior cortical atrophy
• Alzheimer’s disease
• Alzheimer’s visual variant
• visual agnosia
• memory deficit
• Atypical alzheimer’s
• case report

Authors’ contributions

JCB and KCA drafted the manuscript and collected patient information, JCB critically revised the manuscript for intellectual content and supervised the project. All authors have read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Consent for publication

Written informed consent was obtained from the patient.

Ethics approval and consent to participate

The study was approved by the internal review board of Asociación para Evitar la Ceguera en México, I. A. P.

Additional information

Funding

The authors reported there is no funding associated with the work featured in this article.