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Brain, Vol. 114, No. 2, 789-800, 1991
© 1991 Oxford University Press

research-article

A HISTORIC CASE OF VISUAL AGNOSIA REVISITED AFTER 40 YEARS

STEVEN A. SPARR1,, MILTON JAY2, FRANK W. DRISLANE3 and NAGAGOPAL VENNA2

1Departments of Neurology Albert Einstein College of Medicine Bronx, New York 2Departments of Neurology Boston City Hospital Boston, Mass., USA 3Departments of Neurology Beth Israel Hospital Boston, Mass., USA

Correspondence to: Correspondence to: Dr Steven A. Sparr, Department of Neurology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, New York 10461, USA.

In one of the seminal works on visual agnosia, Adler (1944, 1950) presented the case of a 22-yr-old woman who sustained carbon monoxide cerebral toxicity in the Cocoanut Grove nightclub disaster of 1942. We located this patient 40 yrs after injury and performed a detailed reevaluation. The patient demonstrated persistent deficits in visual recognition, characterized most prominently by defective recognition of elemental shape and form, associated with alexia, prosopagnosia, visuospatial disorientation and impaired visual imagery. Visual acuity, colour recognition, writing ability and verbal intelligence were relatively preserved. Isolated bilateral occipital injury was demonstrated by CT and MRI scanning. On comparison with previously reported cases, our results support the hypothesis that carbon monoxide toxicity can induce a visual agnosia of the apperceptive type with well defined characteristics, seldom seen with other types of cerebral injury. Prognosis for long-term recovery is poor.

Received March 7, 1989. Revised April 27, 1990. Accepted May 15, 1990.


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