Abstract：
This paper describes the rehabilitation process of a patient with severe topographical disorientation. The study demonstrates the sustained effects of a tailor-made, meticulous rehabilitation programme based on the gradual development of compensatory strategies. The patient (RB) had a memory impairment specific to environmental landmarks. He was able to recognise objects in his environment, but was unable to identify any salient object as a landmark and was also unable to derive any directional information from a chosen landmark. As such, his topographical disorientation syndrome was complex in that he had elements of both landmark agnosia and a heading disorientation, as described by Aguirre and D\'Esposito (1999). Because of this dual damage to the exocentric framework, the tools and methods used in RB\'s rehabilitation programme were all based on his intact egocentric frame of reference. Remarkable training effects were found for routes he used frequently. After years of training he could walk these routes without the aid of the written information he had used previously, which can be interpreted as a form of implicit learning. In the 12 years we followed this patient some transfer occurred, as the patient was ultimately able to identify his own landmarks. However, RB remains dependent on other people to construct new routes for him on the basis of these landmarks.
摘要：
本文描述了患有严重地形学定向障碍的患者的康复过程。这项研究证明了量身定制的持续效果，细致的康复方案的基础上逐步制定补偿策略。患者（RB）具有特定于环境标志的记忆障碍。他能够识别环境中的物体，但是无法将任何重要物体识别为地标，也无法从选定的地标中获得任何方向信息。因此，他的地形迷失方向综合症很复杂，因为他既有地标性失认症又有标题迷失方向，正如Aguirre和D\'Esposito(1999)所描述的那样。因为这种对外中心框架的双重破坏，RB康复计划中使用的工具和方法均基于他完整的自我中心参照系。对于他经常使用的路线，发现了显着的训练效果。经过多年的训练，他可以在没有他以前使用的书面信息的帮助下走这些路线，这可以解释为内隐学习的一种形式。在我们跟踪这个病人的12年里，发生了一些转移，因为患者最终能够识别自己的地标。然而,RB仍然依赖于其他人在这些地标的基础上为他建造新的路线。
