EpistemisAgraphesthesia
Specialty: Neurology.
Why it occurs
- Contralateral parietal stroke (ischemia or hemorrhage in the somatosensory association cortex)
- Intracranial expansive processes (parietal meningioma, metastasis)
- Corticobasal Degeneration (asymmetric neurodegenerative disorder)
- Multiple sclerosis with demyelinating plaques in the contralateral parietal lobe
- Parietal focal head injury
Initial workup
Exploration of graphesthesia (drawing simple numbers or letters on the patient's palm with a blunt object while keeping the eyes closed, comparing both sides); high-resolution brain MRI; electroencephalogram if continuous or subtle cortical sensory seizures are suspected.
red flags
Sudden onset unilateral agraphesthesia associated with astereognosia, hemispatial neglect, alexia and conduction aphasia, suggestive of acute ischemic stroke of the middle cerebral artery in its posterior parietal division.
Standard management
- Antiaggregation or platelet anticoagulation as appropriate for the cerebral vascular cause
- Cognitive rehabilitation and occupational therapy focused on the stimulation of the contralateral sensory associative cortex.
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
- 2