Acalculia

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Classification according to ICD-10
R48 Dyslexia and other tool disorders, not elsewhere classified
R48.8 Other and unspecified tool disorders
- acalculia
F81 Localized developmental disorders of school skills
F81.2 Arithmetic disorder (dyscalculia)
ICD-10 online (WHO version 2019)

Under acalculia means the acquired inability to deal with numbers. (For developmental disorders in children, see dyscalculia )

Pathophysiology

The (rare) isolated primary acalculia can occur after damage to the language-dominant (predominantly left) cerebral cortex . The lesion affects, for example, the parietal association cortex or the cerebral convolutions of the angular gyrus and supramarginal gyrus located in the area of ​​the transition between the parietal , temporal and occipital lobes . Often a so-called Gerstmann syndrome (acalculia, alexia , finger / foot toe agnosia , right-left weakness) and / or an angularis syndrome (acalculia, alexia, agraphia , amnesic aphasia ) develops .

Railways leading in and out or the area connected to them can also be affected. Loss of function in higher visual areas can lead to optical acalculia , while deficits in higher acoustic areas can trigger acoustic acalculia . The lesion of parietal association areas that lead to apraxia can lead to so-called ideatory acalculia .

Numeracy also depends on other factors. Thus, a can secondary Akalkulie also be caused by impairment of concentration, memory or voice capability.

The damage can result from cerebral infarction , cerebral haemorrhages, brain tumors, brain injuries, brain infections and other causes that affect the tissue.

Historical and Classification

The naming of the impairment of arithmetic as Akalkulie was made in 1919 by Solomon Henschen . He differentiated acalculia from aphasia, which often occurs at the same time.

The first more precise functional division into optical , acoustic and ideatory acalculia was made at the same time by Peritz. Kleist recognized the connection, above all, between ideational acalculia and apraxia , which often occurs at the same time .

In 1926 Berger divided acalculia into secondary acalculia as a disturbance of memory, concentration, language and reading ability and primary acalculia as a direct arithmetic weakness without these disturbances. Primary Akalkulia was further divided by Grafman in 1988 into memory disorders in the retrieval of mathematical facts and disorders of the understanding of mathematical concepts.

Case descriptions

In 1961, Hécaen and colleagues described various possible clinical subtypes of acalculia . So they observed an alexia and agraphy for numbers with preserved recognition and writing ability for letters. Also, a spatial Akalkulie with disturbed perception of multi-digit numbers with multiple digits has been described by them.

In 1996, Cohen and Dehaene were able to demonstrate (in split brain patients) that the non-language-dominant hemisphere is also capable of recognizing and using numbers.

See also

Individual evidence

  1. ↑ Acalculia - disorders of numeracy. In: H.-O. Karnath, P. Thier: Neuropsychology. Springer, Berlin et al. 2003, ISBN 3-540-67359-8 , p. 430ff.
  2. ↑ a b c Georg Peritz: On the pathopsychology of computing. In: German journal for neurology. Vol. 61, 1918, ISSN  0367-004X , pp. 234-340, doi : 10.1007 / BF01658783 .
  3. ^ A b Hans Berger: About arithmetic disorders in herder diseases of the cerebrum. In: Archives for Psychiatry and Nervous Diseases. Vol. 78, No. 1, 1926, ISSN  0003-9373 , pp. 238-263, doi : 10.1007 / BF01996620 .
  4. ^ Salomon Eberhard Henschen: Clinical and anatomical contributions to the pathology of the brain. Volume 5: About aphasia, amusia and acalculia. Nordiska Bokhandeln, Stockholm 1920.
  5. ↑ Karl Kleist : Brain pathology primarily due to the war experience. In: Otto von Schjerning (Hrsg.): Handbook of medical experience in the world wars 1914/1918. Volume 4: Karl Bonhoeffer et al. (Ed.): Mental and nervous diseases. JA Barth, Leipzig 1934, pp. 343-1408.
  6. ↑ Acalculia. In: François Boller, Jordan Grafman (eds.): Handbook of neuropsychology. Volume 1. Elsevier, Amsterdam 1988, ISBN 0-444-90493-X .
  7. ↑ H. Hécaen, R. Angelergues, S. Houillier: Les variétés cliniques des acalculies au cours des lésions rétrorolandique: approche statistique duproblemème. In: Revue Neurologique. Vol. 105, 1961, ISSN  0035-3787 , pp. 85-103.
  8. ↑ L. Cohenab, p Dehaeneb: Cerebral networks for number processing: Evidence from a case of posterior callosal lesion. In: Neurocase. Vol. 2, No. 3, ISSN  1355-4794 , pp. 155-174, doi : 10.1080 / 13554799608402394 .