Prosopagnosia

Prosopagnosia, or face blindness, is a neurological condition characterized by the inability to recognize familiar faces despite normal vision and intelligence. It is a selective impairment of face recognition, and may affect recognition of famous individuals, friends, or even the person’s own reflection while other object recognition remains intact.

Causes and brain basis: Prosopagnosia can be acquired after brain injury or stroke, or develop congenitally without evident brain injury. The condition is associated with dysfunction in a distributed neural network involved in face processing, including the fusiform face area in the fusiform gyrus, the occipital face area, and the superior temporal sulcus, with contributions from other regions for identity, emotion, and memory.

Symptoms and diagnosis: People with prosopagnosia have difficulty recognizing faces, may rely on non-facial cues such as voice, hairstyle, clothing, or context, and may not be aware until social situations reveal the impairment. Diagnosis typically involves neuropsychological testing and exclusion of general visual or memory deficits; common assessments include face recognition and memory tests, such as tasks with unfamiliar and famous faces, sometimes complemented by imaging.

Management and prognosis: There is no cure, but many individuals develop coping strategies such as using distinctive clothing or voice cues, attentive naming, and avoiding face-dependent situations. Support from clinicians, educators, and support groups can help. The condition is usually lifelong, though awareness and adaptation can improve social functioning.