| When seen in clinic,
the patient had no apparent motor deficit: there was no weakness and
no gait abnormality. Although movements of the arms and hands
were fluid and skillful, he had to labor for several minutes to button
a single shirt button because he seemed not to understand how a button
relates to a buttonhole. His repeated efforts to put on a pair of
work gloves were equally unsuccessful, and he ended up with the left
glove on his right hand and 3 fingers where his thumb should go. Throughout
all these efforts his face remained blank, with no indication of either
concern or frustration. He spoke in a monotone. Pinprick, temperature
and touch sensation were normal over both sides of the face, arm and
leg when they were tested separately. However, when tactile stimuli
were presented simultaneously on the left and right, only the right-sided
stimuli were recognized. He could not see objects on his left with
either eye (visual field testing showed an incomplete left homonymous
hemianopsia).
|
|
