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Agnosia |
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Agnosia An impairment in the recognition of stimuli in a particular sensory modality. True agnosias are associative defects, where the perceived stimulus fails to arouse a meaningful state. An unequivocal diagnosis of agnosia requires that the recognition failure not be due to sensory-perceptual deficits, to generalized intellectual impairment, or to impaired naming (as in aphasia). Because one or more of these conditions frequently occur with agnosia, some clinical scientists have questioned whether pure recognition disturbances genuinely exist; but careful investigation of appropriate cases has affirmed agnosia as an independent entity which may occur in the visual, auditory, or somesthetic modalities. See Aphasia The patient with visual object agnosia, though quite able to identify objects presented auditorily or tactually, cannot name or give other evidence of recognizing visually presented objects. Because visual object agnosia is a rather rare disorder, knowledge of its underlying neuropathology is incomplete. Most reported cases have shown bilateral occipital lobe lesions, with the lesion extending deep into the white matter and often involving the corpus callosum. Prosopagnosia is the inability to recognize familiar faces. Persons well known to the individual before onset of the condition, including members of the immediate family, are not recognized. In many instances, individuals fail to recognize picture or mirror images of themselves. Isolated impairment of reading is frequently considered to be an exotic form of aphasia. Logically, however, it may be considered as a visual-verbal agnosia (also referred to as pure word blindness or alexia without agraphia). Individuals with this disorder show a marked reduction in their ability to read the printed word, though their writing and other language modalities remain essentially intact. The term auditory agnosia is most often used to indicate failure to recognize nonverbal acoustic stimuli despite adequate hearing sensitivity and discrimination. In most well-documented cases of agnosia for sounds, the subjects have had bilateral temporal lobe lesions. Auditory-verbal agnosia (or pure word deafness) is a disturbance in comprehension of spoken language, in the presence of otherwise intact auditory functioning and essentially normal performance in other language modalities. The person's speech expression is remarkably intact in comparison with the gross impairment in understanding speech. Like its visual analog, visual-verbal agnosia, this is a disconnection syndrome. It is produced by damage to the left primary auditory cortex (or the tracts leading to it) coupled with a lesion to the corpus callosum. Phonagnosia is a disturbance in the recognition of familiar voices. The person has good comprehension of what is spoken, but the speaker cannot be identified. See Brain, Hearing (human), Hemispheric laterality, Psychoacoustics, Vision |
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[69,73] In one study of patients with RSI,[72] dyskinesthesia (poor dynamic joint position sense) was measured in patients with tendinitis, whereas dysgraphesthesia and astereognosis (problems of inaccuracy when interpreting tactile information through the skin) were measured in patients with focal hand dystonia. |
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