Developmental prosopagnosia and adaptative compensatory strategies: Case study

Prosopagnosia is a type of visual agnosia with inability to identify faces, usually secondary to brain lesion in associative cortex areas, but there is also a congenital form known as developmental prosopagnosia. OBJECTIVES: To describe a case of developmental prosopagnosia that illustrates the specificity of the pathways for perception of faces in the visual system. Also, we will describe possible mechanisms of recognition used by this patient. METHODS: R.S., a 50 year-old woman, was referred for neuropsychological assessment due to difficulties in perception of familiar faces since childhood, unexplained by any loss of visual acuity. RESULTS: The exam showed good performance for comprehension, reasoning, concept formation, constructional abilities, criticism, judgment, mental control, memory and visual perception for other kinds of stimuli. No difficulties were seen regarding identification of ethnicity, age and types of animals. The patient was able to match celebrities’ faces in different positions, but could not identify the matching pictures for unknown people. CONCLUSIONS: These findings indicate the patient had developed strategies, throughout life, to recognize familiar faces (relatives, celebrities) from memorized fragments, but still had difficulties in identifying non-familiar faces holistically.