This is the 2007 version. Click here for the 2017 chapter 02 table of contents.

The Parietal Syndrome

Problems in spatial orientation are produced by damage to the parietal (pear-EYE-it all) lobe, typically in the right hemisphere. Spatial abilities are used when one forms a "mental map" of an area, or when one figures out how shapes will fit together.

What problem is caused by parietal lobe injuries? What are signs of disordered spatial processing?

Patients with parietal damage in the right hemisphere may lose their ability to perform spatial processing. For example, in the acute phase (soon after injury) they get lost easily. If they leave their hospital rooms to get a snack, they may wander around aimlessly until some helpful person shows them the way back to their room. One family realized a middle-aged man was ill when he got lost on the way home from a factory-a route he had traveled twice a day for thirty years. Doctors found he had suffered a stroke in the parietal lobe of the right hemisphere.

What typically happens with the passage of time?

Gradually, as time passes, patients with parietal injuries show fewer symptoms. This recovery of function is typical of many brain-injured patients. In general, the first six months following brain injury are critical; if a patient fails to improve during this time, the long-term outlook for improvement is poor.


Teuber's map

What test did Teuber devise to show the effects of parietal injury?

After a few months, the typical patient with moderate parietal lobe damage shows almost no symptoms. However, a residual deficit (a remaining problem) can be demonstrated with a simple test, described by Teuber (1963). The doctor gives the patient a card with a little map on it. The map consists of nine dots, in rows of three, connected by an irregular line.

On the floor of the examining room is a similar pattern of nine dots, in three rows of three. The patient attempts to follow the path shown on the card, walking between the dots on the floor. Parietal patients have difficulty doing this. They reach a corner, turn around, and (no longer able to relate the card to the floor pattern) they get lost.


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