Difference between Anomia/Agnosia/Dementia?

Question

I have to admit it's an assignment, i've already done some reading on it and i am still unable to decide which symptom it is. Put it short, I've distilliated it into list of symptoms:

Problem of Patient:
1. Unable to name individual and Objects. Both Familiar Object of famous people.
2. Patient tend to substitude words to name objects
3. Unable to do well on Picture-to-Word matching task
4. Cannot generate words in catagories (Animal: Dog, Cat, Duck..), but can generate Letter fluency (L: Let, Lest, Less...)
5. Bad Word Memory

Property of Patient:
1. Can generate past Experience
2. Have no problem with daily activity and care of self.
3. Normal Short Term Memory
4. Normal Verbal Repetition
5. Normal Line Orientation Test
6. Normal Copy/Recall of Complex figure
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NOW, POSSIBLE SYMPTOM I COME UP WITH:
1. Associative Agnosia
2. Anomic Aphasia (Anomia)
3. Dementia

Which one you agree on? Run out of word count.. Any further recommandation on further tests to do?

If possible, please provide justification on the answer. As possible area of lesion, to my understanding it seems like a Left inferior temporal damage. What do you guys think?

Answer 1

Yes, this is a very classical example of an aphasia associated with a left temporal-parietal lesion. The patient is demonstrating 1. anomia, 2. semantic paraphasic errors. 3. impaired confrontational naming 4. this symptom is odd b/c it usually the reverse in clinical practice- Semantic fluency (i.e. category) is 95% of the time superior to phonemic fluency. However, some like to make the distinction that category naming is more temporally mediated and letter naming is frontally mediated. So, I guess your teacher is going with this distinction. So, let's go with it. 5. Bad word memory- I guess you mean impaired verbal recall, as verbal memory is said to be mediated by the left temporal region.

Now the rule outs.... It is clearly not an agnosia as there is no description of a recognition impairment and AD'S are fine and it is clearly not dementia b/c you need impaired short term memory, visual spatial impairment, impaired ADL's as well as anomia and a decline in function overtime.

Your pt most likely had a sudden onset of symptoms associated with a cva or a gradual onset with a tumor

Answer 2

Agnosia Dementia

Answer 3

My vote is for Anomic Aphasia (Anomia). People with aphasia have difficulty with word retrieval, but their memory is intact. It's like being stuck with the "tip of the tongue" annoyance permanently. So, when you are working with a person with aphasia, if you hand them a pen, and ask, "what is this?" They may start describing it, "You write with it....um.. it has ink in it... um..." but they may not be able to tell you it's a pen.

There are several specific tests for aphasia, like the Boston Assessment of Severe Aphasia or the Boston Naming Test. You can also administer an intelligence test, like the WAIS-III which will give you a lot of information from the verbal subtests.

The damage varies, but it is often due to a discrete vascular lesion of the parietal lobe near the angular gyrus or above it. It has also been reported in association with lesions of the left pulvinar region of the thalamus.

Answer 4

No. 2 Aphasic Anomia

Agnosia is a more generalized forgetting.

Dementia is forgetting and loss of daily living skills.

Just a short answer.

Answer 5

To me, this sounds like moderate dementia or moderate alzheimers disease because of the memory loss.