Occupational Therapy in Integrative Visual Agnosia and Memory Disorder: A Case Report

Visual agnosia is a rare symptom in which the patient cannot recognize objects by visual perception. We report a case of integrative visual agnosia and memory disorder. A 70-year-old, right-handed man was diagnosed with cardioembolic stroke affecting the proximal left posterior cerebral artery. He had a short-term memory disorder. He could not name and explain how to use objects, or read characters, but could discriminate between objects to some extent and draw copies of simple figures. His recognition by tactile sense was comparatively preserved. He needed complete assistance with his life in the hospital ward. We provided him with training using preserved tactile sensation by errorless learning. We arranged the environment around him to promote his memory of the position of objects and to avoid misuse of daily objects. Improvement in the visual agnosia and memory disorder was slight. He became independent with his life in the hospital ward. However, he needed assistance in a new environment, such as an unfamiliar lavatory. The results suggest that a patient with visual agnosia may become independent early by appropriate training, despite insufficient visual perception and memory function. In our patient, the intervention period was too short to generalize the effects of training. Additionally, the memory disorder might have become an obstacle for generalization. Further improvement in visual perception, independence in daily activities, and quality of life, will need continuous support.