Singular case of the driving instructor: Temporal and topographical disorientation

Abstract

Lesions of the medio-parietal lobes are linked with topographical and temporal disorientation, and are of interest to understanding mental time. We examined a 39-year-old man who worked as a driving instructor before cerebral hemorrhage, and followed his case for 8 years including neuropsychological testing and brain imaging. The patient had mild anterograde episodic amnesia, but no semantic amnesia. He felt that time passed too quickly, and developed a compulsive routine to compensate, although he was able to count time at a normal speed. Furthermore, he was unable to accurately sketch the layout of his house and to make a cross-reference type timetable for the future. Brain magnetic resonance imaging showed lesions of the left anterior–posterior cingulate gyrus, and N-isopropyl-[123I] p-iodoamphetamine single-photon emission computed tomography showed decreased blood flow mainly of the left medio-parietal lobe.