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PubMed1994

Right unilateral agraphia following callosal infarction in a left-hander.

A left-handed Japanese man is reported who presented right-hand agraphia and tactile anomia following callosal infarction. Magnetic resonance imaging revealed an ischemic lesion extending from the posterior half of the trunk to the splenium of the corpus callosum. In his right handwriting, the 'Kana' (phonogram) was more severely impaired than the 'Kanji' (ideogram), and the most frequent typewriting error was morphological followed by neographism. His visuoconstructional ability was also more impaired in the right hand than in the left. Right-hand agraphia in our case is readily explained by the right hemisphere dominance both for language and visuoconstructional ability.

Agraphia↗
PubMed2006

Acquired alexia with agraphia syndrome in childhood.

The acquired alexia with agraphia syndrome is a conspicuous disorder of reading and writing in the absence of significant other language impairments that has mainly been recorded in adults. Pure cases are rare, with most patients displaying mild aphasic deficits. In children, acquired reading and writing disorders are generally reported as part of more encompassing aphasic syndromes affecting oral and written language equally, for example, Broca or Wernicke aphasia. Documented instances of predominant acquired reading and writing disorders in childhood are exceptional. We report an 11-year-old, right-handed boy who sustained a left temporoparieto-occipital hematoma following rupture of an arteriovenous malformation and who consecutively presented with the acquired alexia with agraphia syndrome associated with word-finding difficulties. Neuropsychologic and neurolinguistic data showed that there was no concomitant Gerstmann and/or angular gyrus syndrome. Th e recoveryfrom the anomia was quite favorable, but recovery of written language was more protracted and acted on the patient's further scholastic achievement. This case is reminiscent of a historical childhood case reported in 1939 and is consonant with adult cases in terms of lesion location and semiologic picture.

Agraphia↗
PubMed1983

Phonological agraphia: writing by the lexical-semantic route.

Two writing routes (phonological and lexical) have been postulated. We studied four patients who had disruption of the phonological route (ie, inability to write pronounceable nonwords) but with a preserved lexical route. Results showed that the phonological route has two components: segmentation and phoneme-grapheme conversion. Disruption of either function may induce phonological agraphia. The preserved lexical route uses a whole-word mechanism and is strongly affected by semantic factors, such as imageability, emotionality, and grammatic class. Results of CT suggest that a portion of the supramarginal gyrus is the most likely anatomic substrate of phonological agraphia.

Adult↗
PubMed1985

Phonologic agraphia in a left-handed patient after a right-hemisphere lesion.

Oral and written spelling were evaluated in a left-handed patient with a right-hemisphere infarct and right-hemisphere language representation. Spelling was intact for different classes of words, but there was severe difficulty in both oral and written spelling of nonwords. This pattern was consistent with phonologic agraphia. There was selective disruption of the segmentation component, with intact phoneme-to-grapheme conversion supporting the Roeltgen and Heilman hypothesis of two-system spelling after lesions in the left supramarginal gyrus. This is the first case of phonologic agraphia after right supramarginal gyrus damage in a left-handed patient.

Adult↗
PubMed1998

Ictal agraphia: a patient study.

We present a case of "pure" or "apraxic" agraphia, a recognized writing disturbance, caused by intermittent focal seizures from the left posterior parasagittal parieto-occipital region. Pure agraphia has been described in focal lesions or as part of a generalized confusional syndrome. The posterior cerebral vascular territory is the characteristic site for the transient neurologic syndromes associated with cyclosporine toxicity. Our patient was at risk for this complication while recovering from a lung transplant, with elevated cyclosporine levels.

Agraphia↗
PubMed2000

Apraxic agraphia due to thalamic infarction.

The authors report a patient of pure apraxic agraphia with normal praxis due to left thalamic infarction. 15O-gas-PET showed reduced oxygen metabolism in the left thalamus and the left dorsolateral premotor area, while MRI and 11C-fulumazenil-PET showed no remarkable lesions in the frontal cortex. The patient's word imaging remained normal. The authors hypothesize that thalamic destruction causes pure apraxic agraphia by exerting a remote effect on left dorsolateral premotor area and blocking somewhere between graphemic area and motor programming.

Aged↗
PubMed1999

[A case of pure agraphia with a deficit of drawing].

We examined a drawing ability in a case with pure agraphia. The patient, having lesions in the left middle frontal gyrus and inferior parietal lobule, could not write in both dictation and spontaneous writing tasks, with the ability to copy letters being well spared. Correspondingly, he showed a deficit of spontaneous drawing, with the ability to copy complex figures being well spared. These findings suggest that he could have an impairment of retrieving visual image, not restricted to letter image. Although some previous cases with pure agraphia were attributed to an impairment of retrieving visual letter image, drawing ability which seemed to be related to retrieving visual image had not been investigated. In the present case, disability of both writing and drawing could be attributed to a common mechanism, that was an impairment of retrieving visual image. In addition, the patient did not show a significant difference between the performance on Kana writing and on Kanji writing. But it has been said that an impairment of retrieving visual letter image could be related to a deficit of Kanji writing more than of Kana writing. Then, it could be assumed that the mechanism of Kana writing involved not only the pathway depending on graphical motor pattern but one depending on visual image.

Agraphia↗
PubMed1975

Frontal agraphia, (including a case report).

Frontal agraphia has always been a subject of interest, although very few documented case reports have been published. A 57 year old male clerk, suffering from adenocarcinoma of the signoid colon, presented with mild headache and difficulty in writing. Minor features of dysphasia could be detected, but there were no alexia, agnosia or apraxia. Brain scan and angiography confirmed a metastasis in the posterior part of the left prefrontal region. The patient was able to write single letters, and had no difficulty with automatic writing or copying. The writing of words and of sentences was more affected. After a brief review of the literature and discussion, the authors concluded that frontal agraphia is related to frontal lobe diorders, especially the inability to translate verbal signals into motor behaviour (i.e. writing).

Adenocarcinoma↗
PubMed1992

[Naming difficulties seen in a case of alexia with agraphia caused by a left postero-inferior temporal lesion].

A 71-year-old right-handed man presented writing and reading difficulties as well as naming difficulties. Neuropsychological examinations revealed mild fluent type aphasia accompanied by alexia and agraphia predominantly affecting kanji and also severe naming difficulties. Brain MRI showed cerebral subcortical hemorrhage extending from the anterior one-third of the left temporal lobe to the temporo-occipital junction involving the fusiform gyrus. The analysis of the several reported cases with severe alexia with agraphia for kanji including ours revealed a close correlation between the severity of kanji writing disturbances and that of naming difficulties. It was also shown that cases with severe naming difficulties had lesion extending anteriorly to the anterior middle temporal gyrus or medially to the parahippocampal gyrus, suggesting that the disconnection between the parahippocampal gyrus and other cortices including the temporal lobe was essential for production of naming difficulties.

Aged↗
PubMed1987

Alexia without agraphia and associated disorders: importance of recognition in the rehabilitation setting.

Alexia without agraphia is readily recognized in its pure (without other neurologic findings) but rare form. However, this deficit is more common when associated with other behavioral disturbances that result from trauma or cerebral infarction to the posterior cerebral hemispheres. Two cases presented with alexia without agraphia following infarction within the posterior cerebral artery territory. Because of initial confusion and disorientation the patients were diagnosed as demented and unsuitable for rehabilitation. Both subjects had a visual field deficit and color agnosia. Prosopagnosia, simultanagnosia, and ataxia of visual-motor control were also present. The second case was unusual because of pure word blindness associated with a right occipital lobe lesion. Only a few such cases have been reported in the literature worldwide. This paper demonstrates that careful delineation of cognitive deficits permits greater understanding of functional disorders with improved rehabilitation outcome.

Aged↗
PubMed1977

[Alexia without agraphia (clinicotomographic correlation)].

Two cases of alexia without agraphia, one due to a cerebrovascular accident which improved spontaneously and the other in a cerebral abscess partially recovered after surgical treatment are presented. Both were anatomically verified by computed tomography. The second was also verified at surgery. A small well localized lesion of the fusiform and lingual gyri in the dominant hemisphere can lead to alexia without agraphia. The lack of involvement of the optic radiation and calcarine fissure explain the abscence of visual field defects and hence the purest type of this syndrome as shown in our first case. The involvement of the splenium of the corpus calosus and related forceps majors seems essential for a long lasting reading defect. The integrity of the dorsal or superior splenium is responsible for the abscence of the color warning defect found on about 30% of the cases of pure word blindness. The severity and ultimate progression of the alexia will depend not only upon the extension of the dominant occipital lesion but of its association with the damage of other possible pathways. A slowly growing and potentially treatable expanding lesion, as in our second case, can also produce an almost pure form of the syndrome. It appears to us that the wider use of CT will allow on the near future will lead to a better knowledge of the anatomical lesions and a better understanding of this fascinating syndrome.

Adult↗
PubMed1977

A different form of "pure agraphia": syntactic writing errors in a patients with motor speech and movement disorders.

Three patients are described who displayed syntactic writing errors in combination with a motor speech disturbance and impaired motor limb function. Two of the patients had bulbar amyotrophic lateral sclerosis (ALS). Agraphia appeared when verbal communication was no longer possible. Autopsy in one patient disclosed only lesions consistent with ALS. The third patient had palilalia and chorea and although not aphasic, his written language showed persistent syntactic errors. We hypothesize that the agraphia in these patients occurred because of the combination of disordered feedback from the motor speech apparatus and limbs.

Adult↗
PubMedDate not supplied

[Agraphia, cortical anarthria and planning disorders as a result of a lesion of the right hemisphere in a right-handed patient].

A right-hemisphere premotor cerebral infarct in a right-handed man from a largely left-handed family caused cortical anarthria and constructional agraphia. The effect of programming difficulties on impaired oral and written expression was demonstrated by the clinical picture of pure agraphia, which could thus be attributed to a primary disorder of programming. Measurements of cerebral blood flow three months after the accident showed that language representation was ambilateral.

Aged↗
PubMed1983

[Agraphia and preservation of music writing in a bilingual piano teacher].

A bilingual virtuoso piano teacher developed aphasia and amusia, probably due to cerebral embolism. The perfectly demarcated and unique lesion was located in the left posterior temporoparietal region. Language examinations in French and Italian demonstrated entirely comparable difficulties in both languages. The linguistic course was favorable after a period of auditory agnosia and global aphasia. Language became fluent again 3 months after the onset, with a marked vocabulary loss and phonemic paraphasias with attempts at self-correction. Repetition was altered markedly with a deficit in auditory comprehension but no remaining elements of auditory agnosia. Reading was possible, but with some difficulty and total agraphia and acalculia persisted. Musical ability was better conserved, particularly with respect to repetition and above all to writing, the sparing of the latter constituting a fairly uncommon dissociation in relation to agraphia. Findings are discussed in relation to data in the literature concerning hemispheric participation in various musical tasks.

Agraphia↗
PubMed1983

[Case of Moyamoya disease with agraphia caused by a frontal lesion].

A 45-year-old woman showed agraphia and decreasing spontaneity. She was diagnosed as Moyamoya disease by cerebral angiography. CT scans revealed the abnormal low density area in the left frontal lobe, and the regional cerebral blood flow study showed low perfusion in the bilateral frontal lobe and the left high convexity area. She could copy specimens of the author's writing, but her spontaneous writing and dictation were impaired with either hand. The form of each letter she wrote was not so distorted, but wrong letters were substituted for the correct ones. Errors in Kana-writing were more common than in Kanji. Although her spontaneous speech was diminished, auditory comprehension, reading and constructional abilities were unaffected. She exhibited no agnosia and apraxia. Agraphia in this case was caused by a disconnection between the visual image and auditory image and/or between the visual image and kinesthetic image. Inner speech (Luria, AR et al, 1968) in this case might be disturbed, and decreasing spontaneity and delay of response resulted from the frontal lesion. The writing process may be constituted of many factors; images of visual, auditory and kinesthetic as well as primary functions of sensory and motor. Furthermore, it may be necessary for normal writing that one's inner speech, activities and intention of writing behavior are intact.

Agraphia↗
PubMed1995

Alexia without either agraphia or hemianopia in temporal lobe lesion due to herpes simplex encephalitis.

We report a case of alexia without either agraphia or hemianopia following herpes simplex encephalitis. The patient had a temporal lobe lesion with involvement of the occipitotemporal gyrus. This is an unusual cause of alexia without agraphia. The location of the lesion supports the view that transcallosal fibers from the right hemisphere to the left angular gyrus course inferior to the posterior horn of the left lateral ventricle and pass close to the left occipitotemporal gyrus.

Acyclovir↗
PubMed1998

Evolution of a form of pure alexia without agraphia in a child sustaining occipital lobe infarction at 2 1/2 years.

The progress of cognitive visual dysfunction over an 8-year period of a child who sustained bilateral occipital-lobe infarctions at the age of 2 1/2 years is described. She survived with normal intelligence and went on to attend mainstream school. She manifested many features of cognitive visual impairment and, in particular, developed a form of pure alexia without agraphia. She achieved some letter-by-letter reading but no sight vocabulary development, including to her own name. She learned to write imaginatively employing phonetically true spelling but cannot read what she has written. Her progress and the difficulties encountered during the management of her condition are discussed in this first case report of the evolution of pure alexia without agraphia in childhood. The features of this syndrome in the developing child who has never developed the capacity to read are contrasted with that seen in affected adults.

Agraphia↗
PubMed2004

Alexia without agraphia following cerebral venous thrombosis associated with protein C and protein S deficiency.

A 26-year-old right handed female was admitted to hospital with right homonymous hemianopia associated with alexia without agraphia. Her cranial magnetic resonance imaging and magnetic resonance angiography revealed a left occipital venous infarction due to thrombosis of the left transverse, sigmoid sinuses and the left internal jugulary vein. The underlying conditions were protein C and protein S deficiency associated with the use of oral contraceptives. To our knowledge, alexia without agraphia has never been described due to a venous infarction associated with hereditary thrombophilia in the literature.

Adult↗