Topographical disorientation in a patient with late-onset blindness with multiple acute ischemic brain lesions.

The neurological basis for topographical disorientation has recently shifted from a model of navigation utilizing egocentric techniques alone, to multiple parallel systems of topographical cognition including egocentric and allocentric strategies. We explored if this hypothesis may be applicable to a patient with late-onset blindness. A 72-year-old male with bilateral blindness experienced a sudden inability to navigate after suffering a stroke. Multiple lesions scattered bilaterally throughout the parietal-occipital lobes were found. Deficits in the neural correlates underlying egocentric or allocentric strategies may result in topographical disorientation, even if one appears to be the predominant orientation strategy utilized.