title: A case of complex regional pain syndrome with agnosia for object orientation.
abstract: This systematic investigation of the neurocognitive correlates of complex regional pain syndrome (CRPS) in a single case also reports agnosia for object orientation in the context of persistent CRPS. We report a patient (JW) with severe long-standing CRPS who had no difficulty identifying and naming line drawings of objects presented in 1 of 4 cardinal orientations. In contrast, he was extremely poor at reorienting these objects into the correct upright orientation and in judging whether an object was upright or not. Moreover, JW made orientation errors when copying drawings of objects, and he also showed features of mirror reversal in writing single words and reading single letters. The findings are discussed in relation to accounts of visual processing. Agnosia for object orientation is the term for impaired knowledge of an object's orientation despite good recognition and naming of the same misoriented object. This defect has previously only been reported in patients with major structural brain lesions. The neuroanatomical correlates are discussed. The patient had no structural brain lesion, raising the possibility that nonstructural reorganisation of cortical networks may be responsible for his deficits. Other patients with CRPS may have related neurocognitive defects.
authors: Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK School of Psychology, University of Queensland, St. Lucia, Brisbane, Australia The Royal National Hospital for Rheumatic Diseases, Bath, UK The Royal National Orthopaedic Hospital, Stanmore, UK Pain Management Centre, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK Pain Research Institute, University of Liverpool and the Walton Centre NHS Trust, Liverpool, UK.
authors: Gail
authors: G
authors: Robinson
authors: Helen
authors: H
authors: Cohen
authors: Andreas
authors: A
authors: Goebel
mesh_terms: D000368:Aged; D000377:Agnosia / Q000150:complications*; D003072:Cognition Disorders / Q000209:etiology*; D020918:Complex Regional Pain Syndromes / Q000150:complications*; D004192:Discrimination, Psychological; D007839:Functional Laterality; D006801:Humans; D007100:Imitative Behavior; D008297:Male; D009483:Neuropsychological Tests; D009949:Orientation; D010364:Pattern Recognition, Visual / Q000502:physiology; D011597:Psychomotor Performance; D011932:Reading