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Running Head: AGNOSIA
Neurological dysfunctions refer to the disorders of the nervous system. The different abnormalities in the structural, electrical or bio-chemical activities in brain and the spinal cord result in various forms of neurological disorder. There is a list of known neurological disorders of which now, some are very common. These neurological disorders can be evaluated with the help of neurological examination and then it can be treated with neurology or clinical neuropsychology. Interventions in the field of neurology have become an important aspect as the interventions help the diagnosed patient to prevent the effects of disorder. Such interventions help them in changing their lifestyles, pain management, medication, physiotherapy and neuro-rehabilitation. In the year of 2006, WHO (World Health Organization) approximated the research result and concluded that the disorder along with its sequel affected one billion people all over the world. And also the research provided evidence that due to these disorders, many health inequalities and discrimination from society, contribute to the suffering and disability of the patient.
Agnosia is a neurological dysfunction or disorder in which the affected patient is unable to recognize other people, objects, places, shapes, smell and voices of other living things. This neurological disorder is concerned with the neurological injury or illness, especially when the occipitotemporal lobe (part of the ventral stream) is damaged (Zoltan, 2009). When Agnosia affects the person, only one modality of function is disturbed or affected by the disorder, such as, voice or vision or other. The ability of the five senses (smell, touch, hear, taste and vision) is incorrectly evaluated by the patient and eventually ending in the wrong direction. A common problem with these patients is that they do not appropriately acknowledge the visceral information of full urinary bladder or any internal pain in their body. This becomes an issue for them and their family members too.
The symptoms of Agnosia are numerous which include inabilities such as:
- To recognize familiar objects,
- To recognize familiar sounds,
- To recognize familiar people,
- Tom recognize familiar shape,
- To recognize familiar stimulus,
- To recognize parts of body,
- To distinguish between different directions (SMALL, SMALL, MILSTEIN, & MOORE, 2010).
All these above stated signs and symptoms are associated with all the various types of Agnosia present which affects the life of an individual while impairing the basic functions of the patient.
Agnosia is a neurological disorder which may affect any part of the brain and the affected brain structure determines which type of Agnosia is it. Agnosia is of mainly three types, visual, tactile and auditory. The visual Agnosia is the most common, probably, due to large size of the visual system in humans. The different types of Agnosia are:
- Visual Agnosia: Visual Agnosia is concerned with the occipital lobe and its pathways which are responsible for the information processing of the incoming vision. This category of Agnosia is further divided in to Associative and Apperceptive Agnosia:
- Associative Agnosia: it is concerned with the inability to recall the information related to any object. This can consist of a variety of facts about the object such as its name, what is it used for, from where it came and many others. This type of Agnosia patients can capture the object’s picture in their mind but if they are asked later about the object they cannot tell it although they would have recognized it.
- Apperceptive Agnosia: it is associated with the assembling of parts in any image. These patients are unable to design the image in an understandable form. The patients face difficulty in recognizing the relationship of objects and images with others. People with this Agnosia can, however, use their vision to navigate and pick objects which they want from the environment easily.
- Prosopagnosia: Prosopagnosia is a disorder in which the patients are unable to recognize faces. Patients with this type of Agnosia have difficulty in recognizing the faces and develop a unique pathway of facial recognition in their brains.
- Pure Alexia: It is associated with the word recognition. Patients of this type of Agnosia face difficulty in recognizing words visually and are unable to read due to this and they cannot speak fluently too.
- Akinetopsia: It is concerned with the motion perception. Patients with this see different still objects moving under the strobe light.
- Pure Word Deafness: it is a type of Auditory Agnosia that impairs the patient from understanding the listened words. But this inability does not impairs them from reading and writing.
- Phonagnosia: another type of Auditory Agnosia which disables the patient from recognizing familiar voices.
- Astereognosis: it is a tactile Agnosia that disables the patient from recognizing objects with the help of touch sense. These people cannot estimate the size, weight and other parameters of the object, however, they can still draw the picture of the object and read and write its name and recognize it too with the help vision.
- Autotopagnosia: it is a disorder in which the body parts are not recognized by the patient. The awareness of position of various parts, such as limbs, is impaired and the patient does not feel that where his body parts are (Stratton, 2011).
Agnosia is a disorder which affects various regions of the brain depending upon the type of Agnosia it is. In visual Agnosia, the occipital lobe and its pathways that are connected to the parietal and temporal lobes are affected. Lesions in the parietal and temporal lobe are caused by the apperceptive Agnosia (Farah, 2012). Damage to the FFA (Fusiform Face Area) is a cause for the start of Prosopagnosia type. In auditory Agnosia, the disconnection of the sound processing regions of brain with the language centers causes Pure Word Deafness Agnosia and damage to the sound association region of brain causes Phonagnosia. In tactile Agnosia, damage to the left parietal lobe causes Autotopagnosia which is an inability of the patient to recognize the body parts.
The patients of Agnosia have impaired sensual and informscation processing due to which they are not able to carry out their daily life routines normally. They face difficulty in various activities of the day. The visual Agnosia patients are unable to recognize objects, places, buildings, shapes, faces and many other things associated with the sight recognition. However, these patients can recognize the objects by the help of touching (Pierce, 2011). The Auditory Agnosia patients are unable to speak properly and fluently in their language and find it difficult for conveying their message or requirement need to others who can fulfill that. These patients, unlike visual Agnosia, patients can easily recognize objects but if they are asked about the object that what it is, then they cannot answer about it. Whereas, the tactile Agnosia patients face difficulty in understanding the surrounding environment as they see moving objects which are still. Due to this problem they cannot move easily with their life routines and face difficulty in understanding the environment in which they live (Humphreys, 2009).
The patient’s family is an important aspect of the patient’s life as the family is responsible for the well-being and care of the patient, in conditions, where he is unable to recognize the objects and other materials. The family should support the patient and try to remove the disability by making him practice about the different perceptions of objects and other materials in which he is facing problem. The family also faces distress conditions due to patient’s disorder outcomes in which he is unable to recognize that his urinary bladder is full or he is having any internal pain. Due to which these conditions lead to more serious issues in the patient’s life and his family too.
For treatment, first the individual should be aware that he is having such type of disorder because many people remain unaware of this condition that what it is. Treatment can improve Agnosia if there is no permanent brain damage. But in adults, recovery is next to impossible if the damage is permanent. Possible and effective treatment methods of Agnosia are as follows:
- Cognitive-Perceptual Rehabilitation: this incorporates different ways of recognition that a patient can opt if recognition has become an issue for him. This treatment also strengthens the pathways that the patient uses in the newly defined ways of recognition. This type of treatment is especially required if there are damages to the brain. This treatment can be done after the initial healing of the brain damage. In this treatment, the tasks are broken into smaller tasks so that the patient can easily do that. In the accomplishment of the tasks, difficulties are easily pinpointed so that the patient can be helped to learn different methods of recognition. For example, the patient of prosopagnosia can easily recognize other familiar people with their hair color or face expressions.
- Visual tracing: this treatment helps the patient to re-develop their writing abilities which they have lost in the disorder. This treatment lets the patients to trace the letters by their fingers and they are asked to trace their finger movements by the eyes. This, soon, helps them to start writing letters with eye movements that mimic the finger tracing movements (Coslett, 2009).
- Exercise and adaptation: certain patients who have Agnosia are encouraged to do exercises which help them recognize the objects and their own body parts. The patients are enabled to practice the objects with their shape and they are asked to match them. The patients of Agnosia are asked to make list of the objects which they use in their daily life so that they can easily fins it when they need them.
Apart from these treatment plans there are many others which have a great impact on the recovery of patient’s abilities and helping them in their daily life routines and surrounding environment.
The patients who recognize that they are having this particular disorder and deficits, treatment are a good choice without any further delay. There are many facilities in the Middle East including UAE where Agnosia is treated. There are hospitals in Dubai which offer the diagnostic tool of SSEP (Somatic-Sensitive-Evoked-Potentials) which helps in recognizing the sensation of the limbs activity which signal is propagated to brain all through the spinal cord. This instantaneously captures the delay and abnormal signals from the sensory inputs due to the different lesions. Other resources include the Fast For Word facility which enables and encourages the patient to improve their word’s pronunciation and writing along with reading abilities. These resources in UAE have contributed a lot to the recovery and re-development of patients with Agnosia.
Agnosia is a neurological dysfunction that impairs the affected patients with performing varous daily life routine work and other surrounding environment is recognized with difficulty or is not recognized at all. The different types of Agnosia impair the patient from three types of sensation that are, vision, hearing and feel sensations. The treatment of the disorder helps them to recover their lost abilities so that they can go on with their daily life routines without any difficulty.
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Farah, M. J. (2012). Visual Agnosia. Bradford Books.
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SMALL, I. F., SMALL, J. G., MILSTEIN, V. P., & MOORE, J. E. (2010). Neuropsychological Observations With Psychosis and Somatic Treatment: Neuropsychological Examinations of Psychiatric Patients. Journal of Neurology, 549-570.
Stratton, G. (2011). Aftereffects of brain injuries in war: their evaluation and treatment. The application of psychologic methods in the clinic. American Journal of Psychological Association, 244-250.
Zoltan, B. (2009). Vision, perception, and cognition: A manual for the evaluation and treatment of the neurologically impaired adult. Journal of Neurologial Disorders, 25-39.