Cognitive deficit

Introduction Agnosia refers to the inability to understand the clinical symptoms of the body parts and familiar objects through organs without sensory insufficiency, mental decline, unconsciousness, and inattention. Lack of cognitive ability including sight, hearing, touch and body parts.

Cause

The occipital lobe is the visual cortical center, which is mainly related to visual acuity and visual memory. The lesions in the 18th and 19th districts cause visual agnosia. The dominant hemisphere temporal lobe auditory area is related to functions such as speech comprehension and auditory analysis. Hearing aphasia occurs when the injury occurs. The parietal lobe is the cortical area responsible for understanding the activity, and is the cortical area based on the concept of behavior. Tactile aphasia and body image loss occur in the injury. In the case of superior hemisphere parietal lobe lesions, both loss of writing, miscalculation, left and right resolution disorders, and finger ignorance can occur at the same time. It is clinically known as Gerstmann syndrome.

The main causes of aphasia are intracranial tumors, cerebrovascular diseases and craniocerebral trauma.

an examination

Related inspection

EEG examination EEG sharp wave brain Doppler ultrasound (TCD)

(1) Cerebravascular disease: The occipital lobe and temporal lobe supply blood mainly from the middle cerebral artery, the posterior cerebral artery and its branches. Arterial occlusion can cause corresponding clinical manifestations, and typical simple agnosia can occur when the extent of the lesion is limited. However, the range of lesions with aphasia is often extensive, generally secondary to post-stroke performance, and other clinical manifestations of middle cerebral artery disease. Agnosia can be detected in diseases such as cerebral infarction, cerebral arteritis, and cerebral artery venous malformation.

(B) brain tumor (intracranial tumour): occipital lobe tumors are mostly glioblastoma, sometimes astrocytoma, clinical central hemianopia and visual hallucinations. When the lesion is in the dominant hemisphere, there may be sensory aphasia, loss of reading and color misrecognition, and loss of recognition at the same time. Non-dominant hemispheres are subject to disappearance and visual space loss. The early stage of temporal lobe tumor is asymptomatic, and the temporal lobe seizure may occur with the development of the disease, mainly due to psychomotor seizures. There is a contralateral 1/4 field of view defect and auditory agnosia, and the main side involvement can cause sensory aphasia. Most of the parietal tumors are metastases, and the clinical manifestations are mostly sensory disturbances, which may include sensory ataxia, decreased muscle tone, muscle atrophy and tactile inattention. Non-main hemisphere involvement may have apathy and autism. Gerst-mann syndrome can occur with primary involvement.

(3) Trauma: Brain contusion and intracranial hematoma occurring in the sac, apical and occipital lobe can cause aphasia.

(4) intracranial infection (otracranial infection): otogenic brain abscess accounts for more than half of all brain tumors, most of which are located in the middle and lower part of the temporal lobe, or in front of the cerebellar hemisphere, the lateral part. Blood-borne infections are more common in the arterial supply area of the arteries, and autism may occur in focal symptoms of the nervous system. Patients may have primary lesions such as paranasal sinus, middle ear, mastoid, skull infection, lung abscess, empyema or congenital purpura heart disease. There may be fever at the beginning of the disease, and the granulocytes and proteins in the surrounding blood are increased. CT has a diagnostic value. Others such as encephalitis, neurosyphilis, brain parasites, etc. can also cause agnosia.

(5) Others: Pick disease is a kind of degenerative brain disease. In the initial stage, personality and emotional volition disorder are the main symptoms, and the mental decline is not obvious. Late mental decline, lack of initiative, lack of speech, less movement, systemic failure and even death. The course of the disease is up to ten years. Clinical and Alzheimer's disease is difficult to identify. There is data to confirm the increase in zinc concentration in the brain. Urinary zinc excretion also increased. In the early stage of the onset, the intelligent decline is not serious. It may not be highlighted by visual recognition, or the body image loss syndrome may be found. Autism can also be detected by Alzheimer's disease, carbon monoxide poisoning, and the like.

Differential diagnosis

Loss of recognition and loss of naming are two different psychological barriers that cannot be named and do not mean that they cannot be recognized. They can name a part of aphasia patients who only express cognition, describe the name of the article, use the description of the article, and demonstrate the use method. The matching test with the object can not be completed, and the unnamed patient can correctly complete the use of the article and the above test method, except for the name, so the two need to be identified.

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