Case Study presented by Katie Stanton and Kevin Schreiber, page 3Neurological Examination
Mental status: Attention IntactLanguage: Intact fluency, comprehension, repetition, naming, and writing. Reading is markedly affected. When asked to read a word or phrase ("bookstore"), he could not read the word "as a whole". He would pronounce each letter individually to spell the word to himself ("b-o-o-k-s-t-o-r-e") and, thus, grasp its meaning. He had no difficulty writing full sentences with correct syntax, both spontaneously and to dictation. However, when asked to read the sentence he had written, he was unable to do so without spelling each letter individually.
Memory:Intact long and short-term memory for verbal and non-linguistic visual information.
Constructional ability: Intact
Abstract thinking: Normal
Calculations: He demonstrated marked difficulty with calculations and could not reliably subtract two 3-digit numbers.
Praxis: There was no evidence of ideomotor or ideational apraxias.
Other higher cortical functions: The patient did not evidence right-left confusion, finger agnosia, achromatopsia, optic ataxia, simultagnosia, or other visual agnosia.
Cranial nerve function:
II Visual acuity is 20/20 OU; pupils are 3mm and reactive to light and accomodation bilaterally; visual field exam shows a right superior quadrantanopsia
III,IV,VI Extraocular movements are intact without nystagmus or ptosis.
V Sensation to light touch and pinprick in all three divisions bilaterally; corneal responses intact bilaterally; muscles of mastication show normal strength.
VII Smile is symmetrical.
VIII Intact to bilateral finger rub.
IX, X Palate and uvula rise symmetrically; gag is intact bilaterally.
X Stemocleidomastoid and trapezius strength intact bilaterally.
XII Tongue is midline without atrophy or fibrillations.
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