EpistemisAgnosia
Specialty: Neurology.
Why it occurs
- Lobar ischemic or hemorrhagic stroke (lesion in visual, auditory or somatosensory association cortices in occipital, temporal or parietal lobes)
- Advanced Alzheimer's disease or other lobar degenerative dementias
- Head trauma with focal cortical contusion
- Herpes encephalitis or other infections with tropism for the temporal and occipital lobes
- Primary or secondary infiltrative brain neoplasms in bilateral associative areas
Initial workup
Detailed neuropsychological evaluation to characterize the type of agnosia (visual, auditory, tactile or somatognosia) and ensure that the primary sensory channels (visual acuity, hearing, tactile sensitivity) are preserved; high-resolution brain MRI; positron emission tomography (PET) with fluorodeoxyglucose in cases of suspected degenerative variant (such as Posterior Cortical Atrophy).
red flags
Acute-onset visual agnosia (e.g., sudden inability to recognize familiar faces or prosopagnosia, or everyday objects) associated with hemianopsia, indicating an acute ischemic stroke of the posterior cerebral artery, a candidate for immediate reperfusion.
Standard management
- Specific etiological treatment of the ischemic or tumor event
- Acetylcholinesterase inhibitors such as Donepezil (5-10 mg/day) or Galantamine if associated with Alzheimer's dementia
- Cognitive neuropsychological rehabilitation therapy for training compensatory strategies (e.g., using auditory or texture cues to recognize objects).
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Neurology
- Listed causes
- 5
- Treatment options
- 3