A Case with Carbon Monoxide Poisoning Presenting Peculiar Unilateral Spatial Agnosia

Abstract

A 9-year-old girl was reported, who presented many neuropsychological symptoms including peculiar unilateral spatial agnosia following anoxic encephalopathy due to carbon monoxide poisoning. After recovering from the comatose state which continued 8 days intermittently, she developed unilateral spatial agnosia, agraphia, apraxia, acalculia and right-left disorientation. Among these, the most interesting symptom was unilateral spatial agnosia. Although there were no disturbance of both visual acuity and visual fields, she showed the left-sided spatial agnosia on the reading and right-sided spatial agnosia on the simulation of movement. This report was the first that the side of spatial agnosia changed according to contents of stimulation at the same period. On the examinations of CT scan and EEG, it was suggested a demyelinated change of cerebral white matter which was considerd as a main lesion of carbon monoxide poisoning.
Considering that the lesion of cerebral white matter includes the corpus callosum in carbon monoxide poisoning, it was suggested that the unilateral spatial agnosia was due to the interhemispheric disconnexion syndrome.