Pure topographic disorientation: A distinctive syndrome with varied localization

Pure topographic disorientation (TD), defined as impaired recall of routes in familiar surroundings, has been attributed to lesions of the right parahippocampus. The authors present three patients encountered consecutively with TD and compare them to previously published cases. Lesions causing TD included a right splenial/cuneus infarct, a right > left medial temporo-occipital infarct, and a left splenial infarct. TD as an isolated symptom may occur from lesion in a variety of posterior medial locations, including the parahippocampus, splenium, and retrosplenial cortex.