Clinical reasoning: progressive visuospatial problems in a 71-year-old man.

Abstract

A 71-year-old right-handed man presented with a 3-month history of progressive cognitive impairment. Six weeks before presentation, he became unable to use his mobile phone, with difficulties pressing the digits in the correct order. He had developed problems reading, describing a jumbled-up appearance of words on the page. He omitted single letters when writing, and had difficulty in using cutlery and accurately judging portion sizes. He had ceased driving due to navigational problems and because of repeatedly hitting the curb. In the last 4 weeks, he had developed difficulty dressing. Notably, he had good insight, being able to give a detailed description of symptoms.