[Inverted or tilted perception disorder]

In the context of the increasing number of reported cases of patients presenting tilt or reversal of vision anomaly (here reviewed), we call the attention to the work of Justo Gonzalo (1910-1986), scarcely known in the contemporary literature. His work deals with that anomaly, and with tactile and auditory inversion, in relation to what he called central and paracentral syndromes, interpreted from the functional model he developed.

Gonzalo makes reference to 25 patients with chronic tilted vision, some of them with almost inverted perception in visual, tactile and auditory systems, under minimum stimulus. The central syndrome is caused by unilateral lesion in the parieto-occipital cortex, equidistant from the visual, tactile and auditory projection areas, and is characterized by bilateral multisensory involvement, and by dynamic effects following physiological laws of nervous excitability. Thus, as the illumination of an object was diminishing, it was perceived progressively tilted, reduced, and losing form and colors, following a physiological order; however the image was corrected by increasing the illumination, or by facilitation through other sensory stimulus. The central syndrome is compared with the reviewed cases.

This syndrome involves a deficit of nervous excitability which would induce an integration deficit, tilted vision emerging as a more common affection than believed. The central syndrome reveals aspects of the cerebral dynamics, suggesting a functional continuity and unity of the cortex. This is reflected in the model that was proposed, based on functional gradations through the cortex and scaling laws of dynamic systems.