Prosopagnosia in Primary Health Care

Prosopagnosia in Primary Health Care

Recently, there has been discussion about the prosopagnosia, a neurological disorder that is characterized by the individual’s difficulty in recognizing faces and can be congenital or acquired. Acquired cases of the disease can be caused by trauma – such as traumatic brain injury (TBI) and stroke – by neurological and psychiatric diseases – such as dementia, Parkinson’s, Alzheimer’s and schizophrenia. Given the situation, it is considered relevant to mention possible repercussions for patient care in Primary Health Care (PHC).

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When considering the main symptom of prosopagnosia, one can reflect on the possible complications for the individual with distortion of their perception. In this sense, some symptoms that concern the individual with this diagnosis are anxiety, depression, stress and social isolation. In view of this, individuals with reports of difficulty in “recording faces” or “recognizing faces” should be welcomed in a humanized way in the PHC, since it is an individual’s gateway to health services.

In this context, the user’s reception can be done by any professional who works in the health unit, in order to listen to him and direct him to the care and investigation of the neurological condition. It should be noted, however, that the diagnosis of the disease is a medical assignment and, although the follow-up must be carried out in a multiprofessional way, in order to minimize the stress of the disease, the patient must be referred to the specialized network for concomitant follow-up.

Anamnesis and Physical Examination

Furthermore, the care provided by the health professional to the user with a complaint of prosopagnosia or other agnosia must take into account the detailed anamnesis and physical examination. Some important issues to be addressed during individual care are:

  • Age;
  • Education;
  • Date of onset of symptoms;
  • Ask about interpersonal relationships;
  • Ask about symptoms of anxiety and depression;
  • Pre-existing diseases and conditions;
  • History of traumatic brain injury;
  • Medications in use;
  • Use of alcohol and drugs;
  • Application of tests (Face Recognition Self-Perception Scale, Clinical Assessment of Dementia (CDR), Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), visual acuity ― LogMAR and Snellen ― Face Recognition Test Brasileiro, Cambridge Face Perception Test, Glasgow Face Matching Test, Benton Facial Recognition and Caledonian Face Test, among others).

practical message

Faced with this reality, the procedures to be carried out to the patient with this diagnosis refer to the referral to the specialist, to the request of complementary exams for brain evaluation and to multidisciplinary support. It should be noted that although there are no studies that confirm the effectiveness of multidisciplinary therapy for cases of prosopagnosia, there is evidence of improvement for patients with brain trauma, neurological and degenerative diseases.

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Finally, it is important to highlight that monitoring the individual in PHC has its advantage, as well as training the team to have a keen eye, due to the ease of access, comprehensive care, accountability of the family health team, construction of the family bond, the existence of a multidisciplinary team, the Health Care Network (RAS) and Community Health Agents (ACS) ― a professional category that guarantees the visibility of the problems encountered in the enrolled population through observation and bonding during home visits .

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