Site | Symptoms/signs |
Unilateral | Contralateral spastic hemplegia Contralateral gaze paresis Apathy and loss of initiative Elevation of mood, increased talkativeness, joke inappropriately (witzelsucht), lack of tact, difficulty in adaptation |
Left: Broca's aphasia with agraphia, with or without apraxia of the lips and tongue; Sympathetic apraxia of left hand | |
Prefrontal: grasp and suck reflexes | |
Orbitofrontal: anosmia | |
Bilateral | Bilateral hemiparesis Spastic bulbar (pseudobulbar) palsy Decomposition of gait and sphincter incontinence |
Prefrontal: abulia or akinetic mutism, lack of ability to sustain attention and solve complex problems, rigidity of thinking, bland affect, social ineptitude, behavioral disinhibition, inabilty to anticipate, labile mood, and varying combiations of grasping, sucking, obligate imitative movements, utilization behavior |
Site | Symptoms/signs |
Unilateral, dominant | Homonymous contralateral upper quadrantanopia |
Wernicke's aphasia (word deafness; auditory verbal agnosia) Dysnomia or amnesic aphasia |
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Amusia (some types) | |
Visual agnosia | |
Occasionally, amnesic (Korsakoff) syndrome | |
Unilateral, nondominant | Homonymous upper quadrantanopia |
Inability to judge spatial relationships in some cases | |
Impairment in tests of visually presented nonverbal material | |
Agnosia for sounds and some qualities of music | |
Unilateral, either side | Auditory, visual, olfactory, and gustatory hallucinations |
"Dreamy" states with seizure (focal temporal lobe seizure) | |
Emotional and behavioral changes | |
Delirium-confusional states (usually nondominant) | |
Disturbances of time perception | |
Bilateral | Korsakoff amnesic defect (hippocampal formations) |
Apathy and placidity | |
Klüver-Bucy syndrome: compulsion to attend to all visual stimuli, hyperorality, hypersexuality, blunted emotional reactivity |
Site | Symptoms/signs |
Unilateral | Corticosensory syndrome and sensory extinction (or total hemianesthesia if large white matter lesions) |
Mild hemiparesis or poverty of movement (variable), hemiataxia (seen only occasionally) | |
Homonymous hemianopia or inferior quadrantanopia (incongruent or congruent) or visual inattention | |
Abolition of optokinetic nystagmus with target moving toward side of the lesion | |
Neglect of the opposite side of external space (more prominent with right parietal lobe lesions) | |
Dominant (left) | Disorders of language (especially alexia) |
Gerstmann syndrome (dysgraphia, dyscalculia, finger agnosia, right–left confusion) | |
Tactile agnosia (bimanual astereognosis) | |
Bilateral ideomotor and ideational apraxia | |
Nondominant (right) | Visuospatial disorders |
Topographic memory loss | |
Anosognosia, dressing, and constructional apraxias (more frequent and severe with nondominant lobe lesions) | |
Confusion | |
Tendency to keep the eyes closed, resist lid opening, and blepharospasm | |
Bilateral | Balint syndrome: visual-spatial imperception (simultagnosia), optic apraxia (difficulty directing gaze), and optic ataxia (difficulty reaching for objects) |
Site | Symptoms/signs |
Unilateral | Contralateral (congruent) homonymous hemianopia, which may be central (splitting the macula) or peripheral; also homonymous hemiachromatopsia |
Elementary (unformed) hallucinations—usually with irritative lesions | |
Left | Alexia without agraphia if deep white matter and splenium of corpus callosum involved |
Visual object agnosia | |
Right | Visual illusions (metamorphopsias) and hallucinations (more frequent with right-sided lesions) if more extensive lesions. |
Loss of topographic memory and visual orientation | |
Bilateral | Cortical blindness bilateral hemianopias |
Anton syndrome (visual anosognosia, denial of cortical blindness) | |
Loss of perception of color (achromatopsia) | |
Prosopagnosia (impaired face recognition, bilateral temporooccipital including fusiform gyrus) | |
Balint syndrome (bilateral dorsal parietooccipital) |
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