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School of Medicine >
Department of Neurology >
Medical Student Cases and Questions >
A Lawyer Who Could Not Read
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A 53 yo RHWM attorney with a history of hypertension and 2 previous TIA's
involving the vertebro-basilar system woke up one morning quite groggy after
working late on a deposition. He didn't think much of it when he stubbed
his right toes on the edge of the bed and again on the door hinge while
walking into the bathroom. When he sat down at the breakfast table, he began
to work on the deposition from the night before. His wife was sitting to
his left drinking her coffee. The patient asked her "Do you think you could
get me a cup of coffee?" She laughed and told him that his coffee was right
in front of him. The wife had to point out that the coffee cup was just
beside his right hand. The patient began making notes on the cover page
of the deposition. He then opened it and found that he could not read a
single word.
He came to the ER where a neurologist found a normal sensory and motor exam.
There was no evidence of aphasia.
Questions:
- What deficits does the pt have?
- Name this syndrome?
- Where is the lesion?
- Name at least three causes of the syndrome?
- Predict other associated findings?
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