Anton's Syndrome: A Rare Form of Anesognosia, A Case Report

Location

Philadelphia Campus

Start Date

1-5-2013 2:00 PM

End Date

1-5-2013 4:00 PM

Description

Introduction: Anton’s syndrome is characterized by cortical blindness in which, despite all their obvious disability, sufferers insist they can see. Patients will often confabulate and behave as if they are not visually impaired. Their cortical blindness is most often due to bilateral occipital or parietal-occipital strokes. It is believed that in addition to damage to the bilateral primary visual cortices, the damage extends to visual-association cortices, which leads to the patient’s neglect of his or her deficits. The lesions may be simultaneous or sequential in nature and are often due to embolic phenomenon or hypoperfusion. Case Report: A 49 year old African American male presented to the emergency room with right sided weakness, aphasia, confusion and difficulty ambulating. Imaging revealed a subacute to chronic right and acute left parieto-occipital ischemic infarcts due to atrial fibrillation and subsequent mild hemorrhagic conversion due to hypertension. Due to his adamancy that his vision was intact despite his obvious deficits, along with confabulation in response to his visual exams, it was concluded that his symptoms were consistent with Anton’s syndrome.

Conclusion: This case demonstrates a classic clinical presentation of Anton’s Syndrome. The patient’s adamant claims that he can see is distinct from denial, as his claims are not due to a psychological defense mechanism, rather a structural disruption. It is crucial to explain the severity of this condition to patients and family members, as patients with anosognosia have less desire to seek medical rehabilitation. This case also serves as an example that cerebrovascular accidents should be assessed and treated quickly to prevent extension to other areas of the brain. In addition, control of patient risk factors is essential in preventing cerebrovascular accidents.

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May 1st, 2:00 PM May 1st, 4:00 PM

Anton's Syndrome: A Rare Form of Anesognosia, A Case Report

Philadelphia Campus

Introduction: Anton’s syndrome is characterized by cortical blindness in which, despite all their obvious disability, sufferers insist they can see. Patients will often confabulate and behave as if they are not visually impaired. Their cortical blindness is most often due to bilateral occipital or parietal-occipital strokes. It is believed that in addition to damage to the bilateral primary visual cortices, the damage extends to visual-association cortices, which leads to the patient’s neglect of his or her deficits. The lesions may be simultaneous or sequential in nature and are often due to embolic phenomenon or hypoperfusion. Case Report: A 49 year old African American male presented to the emergency room with right sided weakness, aphasia, confusion and difficulty ambulating. Imaging revealed a subacute to chronic right and acute left parieto-occipital ischemic infarcts due to atrial fibrillation and subsequent mild hemorrhagic conversion due to hypertension. Due to his adamancy that his vision was intact despite his obvious deficits, along with confabulation in response to his visual exams, it was concluded that his symptoms were consistent with Anton’s syndrome.

Conclusion: This case demonstrates a classic clinical presentation of Anton’s Syndrome. The patient’s adamant claims that he can see is distinct from denial, as his claims are not due to a psychological defense mechanism, rather a structural disruption. It is crucial to explain the severity of this condition to patients and family members, as patients with anosognosia have less desire to seek medical rehabilitation. This case also serves as an example that cerebrovascular accidents should be assessed and treated quickly to prevent extension to other areas of the brain. In addition, control of patient risk factors is essential in preventing cerebrovascular accidents.