[A syndrome of visuo-verbal and visuo-gestural disconnexion. Optic aphasia and optic apraxia (author's transl)]

Abstract

A 71 year-old female patient was investigated during several months after a double left hemispheric lesion of vascular origin. The larger lesion was temporo-occipital, the second one parietal. The main neurological disorder was a right homonymous hemianopia. Clinical and neuroradiological data confirmed the integrity of the right hemisphere. There was neither a global deterioration of intellectual capacities nor aphasia. In particular, visual agnosia was excluded by a series of matching and functional classification tests. Nevertheless the objects and their pictures, which the patient could recognize, could not be named. The lack of words was limited to the visual modality. No apraxia neither ideomotor nor ideational was present on verbal commands, but the evocation of movements for the use of objects was deficient if the stimulation was visual. This disorder is considered in the frame of the visual-gestural disconnection and thus represents what we propose to call visual apraxia. Further we discuss the disorders of constructive apraxia which are characterized by the poor reproduction of models when executed by the right hand whereas the reproduction by the left hand is incorrect.