Posterior Cortical Atrophy

Synonyms:

Visual variant of Alzheimer’s disease, Benson’s syndrome
 

Clinical features:

  • Features of Gerstmann’s syndrome (Alexia, Acalculia, Agraphia, Left-right agnosia/disorientation, Finger agnosia)
  • Features of Balint’s syndrome (simultanagnosia, oculomotor apraxia, optic ataxia),
  • Apperceptive visual agnosia, dressing apraxia, environmental disorientation, hemianopia, transcortical sensory aphasia
  • Less commonly: memory or language disturbances

Localises to visual association cortex bilaterally, usually due to Alzheimer’s disease. If visual hallucinations are present, diffuse Lewy body disease is the likely cause (thalamocortical & ascending midbrain pathways).
 

Pathology:

Usually neurofibrillary tangles and neuritic plaques similar to Alzheimer’s disease but localized to parieto-occipital cortex or temporo-occipital cortex. Rarely features of diffuse Lewy body disease
 

Findings on Investigations:

CT/MRI: posterior atrophy (parieto-occipital cortex or temporo-occipital cortex)
SPECT/PET: hypometabolism in parieto-occipital cortex or temporo-occipital cortex
 

References:

  1. Benson, D.F., R.J. Davis, and B.D. Snyder, Posterior cortical atrophy. Arch Neurol, 1988. 45(7): p. 789-93.