Pure Topographic Disorientation: A Distinctive Dyndrome with
Varied Localization
T. Alsaadi, J. R. Binder, R. M. Lazar, T. Doorani and J. P. Mohr
From the Department of Neurology (Drs. Alsaadi, Binder, and
Doorani), Medical College of Wisconsin, Milwaukee; and the
Neurological Institute (Drs. Lazar and Mohr), Columbia-Presbyterian
Medical Center, New York, NY.
Pure topographic disorientation (TD), defined as impaired recall of
routes in familiar surroundings, has been attributed to lesions of the
right parahippocampus. The authors present three patients encountered
consecutively with TD and compare them to previously published
cases. Lesions causing TD included a right splenial/cuneus infarct, a
right > left medial temporo-occipital infarct, and a left splenial
infarct. TD as an isolated symptom may occur from lesion in a variety
of posterior medial locations, including the parahippocampus,
splenium, and retrosplenial cortex.
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