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PubMed1979

Alexia without agraphia in a musician after transcallosal removal of a left intraventricular meningioma.

After a meningioma situated in the trigone of the left lateral ventricle was excised by the transcallosal approach of Kempe and Blaylock, a right-handed musician with a right hemianopsia developed alexia without agraphia. In contrast to previously reported cases of this syndrome arising from other etiologies, he was unable to read single letters or numbers. Neuropsychological studies at 42 and 126 days after operation also disclosed an inability to associate auditory or tactile stimuli with visually perceived material, whereas speech and verbal comprehension were intact. Although the alexia extended to musical notes, he could interpret other musical symbols (e.g., treble clef). Appreciation of rhythm and expressive musical ability were relatively preserved, although judgment of other musical features (including discrimination of pitch, duration, and loudness) was compromised. The findings suggest that alexia may occur as a consequence of the transcallosal procedure when a right hemianopsia is present. However, other linguistic abilities may be better preserved by the transcallosal approach to the ventricle than by a transcortical operation.

Agraphia↗
PubMed1996

Brief communication: electromagnetic fields improve visuospatial performance and reverse agraphia in a parkinsonian patient.

A 73 year old right-handed man, diagnosed with Parkinson's disease (PD) in 1982, presented with chief complaints of disabling resting and postural tremors in the right hand, generalized bradykinesia and rigidity, difficulties with the initiation of gait, freezing of gait, and mild dementia despite being fully medicated. On neuropsychological testing the Bicycle Drawing Test showed cognitive impairment compatible with bitemporal and frontal lobe dysfunction and on attempts to sign his name he exhibited agraphia. After receiving two successive treatments, each of 20 minutes duration, with AC pulsed electromagnetic fields (EMFs) of 7.5 picotesla intensity and 5 Hz frequency sinusoidal wave, his drawing to command showed improvement in visuospatial performance and his signature became legible. One week later, after receiving two additional successive treatments with these EMFs each of 20 minutes duration with a 7 Hz frequency sinusoidal wave, he drew a much larger, detailed and visuospatially organized bicycle and his signature had normalized. Simultaneously, there was marked improvement in Parkinsonian motor symptoms with almost complete resolution of the tremors, start hesitation and freezing of gait. This case demonstrates the dramatic beneficial effects of AC pulsed picotesla EMFs on neurocognitive processes subserved by the temporal and frontal lobes in Parkinsonism and suggest that the dementia of Parkinsonism may be partly reversible.

Aged↗
PubMedDate not supplied

Remediation of alexia without agraphia: a case study.

Following a left temporoparietal-occipital haemorrhage and surgery, a 43-year-old, right-handed male exhibited alexia without agraphia. A remediation programme consisted of training in head turning to compensate for a right visual field defect, letter-by-letter reading aloud and covertly, drill with flash-cards to improve word recognition and practice in naming objects to improve dysnomia. The patient's reading improved markedly over a 6-week period and he was able to resume work as a respiratory therapy supervisor. A post-morbid depression resolved concomitantly with the patient's return to work. The training programme and the patient's post-training approach to reading are discussed in terms of hemispheric functioning as well as 'direct path' and 'indirect path' reading. The effectiveness of training is considered in the context of spontaneous recovery.

Adult↗
PubMedDate not supplied

[Alexia without agraphia due to the lesion in the right occipital lobe in a right-handed man. Detection of hemispheric lateralization of handedness and language in a right-handed patient].

INTRODUCTION AND CLINICAL CASE: A 65 year-old man, right-handed, without any family history of left handiness, suddenly developed a left homonymous hemianopia and incapacity for reading. Neurological and neuropsychological examinations showed the presence of a profound alexia with preservation of writing to dictation and spontaneously. He was unable to read what he had written. He could spell the words letter by letter but he was unable to read the complete word. MRI showed an extensive infarct in the territory of the right posterior cerebral artery. The infarct extended anteriously to the right thalamus and to the medial temporal fifth or fusiform gyrus. The splenius was spared. Brain SPECT disclosed the area of the infarct and an extensive area of decreased cerebral perfusion over the right parietal and temporal areas. CONCLUSION: Alexia without agraphia has been reported in right-handed patients with left occipital lesions and in right occipital regions in left-handed patients but rarely if ever in right occipital lesions in right-handed patients.

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PubMed2001

Alexia without agraphia: a century later.

A case of alexia without agraphia is presented. It is a rare but classic disconnection syndrome, first described by Dejerine in 1892. Recent advances in modern neuroimaging techniques such as FLAIR MRI can now localise in vivo the site of origin of the syndrome, especially when computerised axial tomogram of the brain is normal.

Aged↗
PubMed1992

["Left unilateral agraphia with right hemiparesis" after occlusion of the left middle cerebral artery].

This paper presented a case of a right-handed male who showed a right hemiplegia without aphasia and apraxia. He lost the ability to write with the left hand. A 56-year-old right-handed man, who had a daughter of left-handedness, was sent to our hospital with a homonymous hemianopsia, facial weakness, spastic hemiparesis and sensory disturbance in the right side. CT scan revealed an infarction in the territory of the left middle cerebral artery. On a month after the onset, he was alert and oriented. His speech was normal and verbal comprehension was intact. Although he neglected the right side of the page, he could read and comprehend it correctly. In contrast with his normal abilities to speak, comprehend, and read, difficulties in writing were prominent. Spontaneous writing with the left hand was extremely poor, and he even had difficulty writing his own name. His dictation was also poor, but his writing improved with copying letters. Agraphia had seen even after USN was recovered. Analysis of this case suggested the presence of the dominance for speech, comprehension, and praxis in the intact right hemisphere, and writing center in the damaged left hemisphere.

Agraphia↗
PubMed1991

[Visuo-constructional disorders and alexia-agraphia associated with posterior cortical atrophy].

A 57 year-old woman developed a slowly progressive environmental agnosia and dressing apraxia without disturbances of language, memory, orientation and social activities. Two years later, alexia, agraphia, visual agnosia, constructional apraxia, simultagnosia and imitation apraxia of nonsymbolic gestures were also noted. Ophthalmic examination demonstrated a left inferior quadranopsia. Oral comprehension was normal. There was no loss of insight, and behavioral response was appropriately concerned. Computed tomography and magnetic resonance imaging revealed bilateral cortical atrophy in parieto-occipital areas, most pronounced on the right side, with enlargement of the ventricles. Positron emission tomography demonstrated low flow and metabolism values in the right parietal, temporal and occipital regions. This case is very similar to those of posterior cortical atrophy recently reported by Benson et al. (1988). It suggests a selectively degenerative dysfunction of posterior association cortex, sparing oral language and verbal memory.

Agnosia↗
PubMed1989

Alexia with agraphia.

The authors presented a case of relatively pure syndrome of alexia with agraphia in a patient speaking Serbo-Croatian language. Reading disturbances showed some characteristics of a deep dyslexia. Besides severely impaired reading and writing abilities, some components of Gerstamnn's syndrome were also present. Infarction in the posterior half of the left supramarginal and in the anterior half of the left angular gyrus was accurately located by the graphic reconstruction of CT scans.

Agraphia↗
PubMed1989

[A case of left hand agraphia without callosal apraxia].

A 65-year-old male who had agraphia confined to the left hand was reported. The patient was admitted to the neurological department of Kasugai city Hospital because of suddenly-developed mild right-sided hemiparesis with central facial palsy. Computerized tomography of the brain was performed 2 and 14 days after admission. As a result, low-density regions were found in the left cingulate and medial frontal gyri and the trunk of the corpus callosum. Magnetic resonance imaging of the saggital plane more clearly visualized a localized infarction affecting both the trunk of the corpus callosum and its leftward outflow. Neuropsychological findings of the patient were summarized as follows. 1) He had no difficulty in any of the actual use of object, copying the manipulation of objects, and proper use of objects according to verbal commands. 2) With the eyes closed, he could correctly name the objects handed over to the right hand, while he could do only 15 out of 20 objects handed over to the left hand. However, whichever hand an object was handed to, he could explain how to use the object. 3) He could write Hiragana, Katakana, and Kanji correctly with his right hand in accordance with verbal commands, whereas with his left hand he could do only for 20% of Hiragana, 20% of Katakana, and 90% of Kanji. 4) He could copy Kanji, Hiragana, and figures with either right or left hand. 5) He could point out verbally-presented letters using letter cards whether with the right hand or with the left hand, and could also select the letter card corresponding to the letter visually-presented.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMedDate not supplied

[Alexia without agraphia. Anatomical basis and physiopathological mechanisms].

Clinical, neuropsychological and radiological signs were studied in a patient suffering from pure alexia associated with right superior quadrantanopia. The lesion responsible for the defects was located in the periventricular white substance at the level of the left inferior occipitotemporal convolutions. These structures seem to constitute the pathway of the visual information channelled from the two hemispheres towards the language centres. The lesion therefore disconnects the angular gyrus from its visual information and gives rise to alexia without agraphia.

Aged↗
PubMed1987

[Crossed alexia-agraphia in a right-handed patient].

A right-handed man, born of a right-handed family, presented an infarct in the territory of the right middle cerebral artery, with a left hemiplegia, a left lateral homonymous hemianopsia and an expression aphasia. The oral trouble disappeared in some weeks, but later a permanent linguistic deficit persisted, affecting mainly the written language and realizing a clinical picture of alexia-agraphia with Gerstmann's syndrome. The neurolinguistic study showed a preferential alteration of the phonologic system in the written language, and at a lesser degree in the oral modality. The extent of the lesion and the relative integrity of oral expression and comprehension, suggested that these functions were localized in the left hemisphere, whereas lecture, writing, calculation, body-parts notion, laterality notion, had been simultaneously implanted during the ontogenesis in the right hemisphere. The latter was probably also responsible for phonological aspects of written and spoken language, according to a scheme opposite to that of usual right-handers.

Agraphia↗
PubMed1987

[Alexia and agraphia caused by a lesion of the right hemisphere in a non-aphasic right-handed patient].

Oral and written speech centers are commonly attributed to the dominant hemisphere, while body, spatial and facial recognition to the non-dominant. This paper examines the case of a 63 year old entirely right-handed male who presents alexia, agraphia, difficulties in spelling and word-finding together with left spatial and body agnosia, musical, letter and face agnosia, constructional apraxia and left hemianopsia. Computerized axial tomography confirms a right occipital tumor identified as an adeno-carcinoma probably of digestive origin. The role of right hemisphere as a spatial prerequisite to final elaborate speech is discussed.

Adenocarcinoma↗
PubMed1985

[Right neglect with hemiasomatognosia, mental confusion, apraxia and agraphia without aphasia].

A 74 year-old woman was admitted with a right hemiplegia resulting from a left infarct that had totally destroyed the territory supplied by the middle and anterior cerebral arteries. The patient presented with anosognosia and hemiasomatognosia and negligence of the right half-field. She was aprosodic, not aphasic, and there was a severe apraxia and total agraphia. These neuropsychological disorders are discussed in relation to the contradictory data relative to the manual lateralization of the patient. Findings in this case of a "crossed apraxia" show that management of language and of the propositional gestures are not necessarily ensured by the same hemisphere. It also appears that manual preference may be a poor clue for interpretation in terms of functional lateralization.

Aged↗
PubMedDate not supplied

[Anatomical and clinical correlations in a case of alexia without agraphia (author's transl)].

The authors report the anatomical and clinical findings observed in a case of alexia iwthout agraphia due to left posterior cerebral artery infarction, in which there were lesions of the occipital and thalamic regions, the splenium of the corpus callosum, and the hippocampus. They discuss, more particularly, the memory difficulties, and the objects naming trouble.

Agraphia↗
PubMed1982

[Neuropsychological study of crossed aphasia with jargon agraphia].

A case of jargon writing following a right vascular cortico-subcortical lesion in the right sylvian territory of a strictly right-handed patient is presented and analyzed. In spontaneous writings the general graphic form of sentences is present (blanks, punctuation) but a great number of neologisms appear. Disorganisation of oral language in this case of crossed aphasia takes the form of a conduction aphasia. The patient is capable of oral spelling and of writing single letters under dictation. If he is asked to spell orally a dictated word while attempting to write it, his writing is much improved. This observation is contrasted with that of an agraphic patient whose writing is limited to concrete nouns. The analysis of the data obtained confirms the existence of different strategies of graphic encoding recently described in various neuropsychological studies: the agraphia of the crossed aphasic patient is related to the lexical form, that of the second patient is related to the phonological form.

Agraphia↗
PubMed1997

Alexia and agraphia in posterior cortical atrophy.

A 65-year-old woman with progressive visuospatial dysfunction for 2 years complained of later-onset associated memory impairment. MRI revealed diffuse cerebrocortical atrophy, which was especially severe in both parieto-occipital regions but spared the calcarine and pericalcarine cortices. Examination 5 years after onset revealed left visual hemi-neglect, oculomotor apraxia, optic ataxia, simultanagnosia, verbal alexia, lexical and spatial agraphia, and anterograde amnesia. This patient's disorder is considered in the context of previous reports on the array of cognitive disturbances associated with posterior cortical atrophy (pCA). Special emphasis is made on her reading and writing disturbances, because their prevalence and range of individual variability have not been established in pCA. This array of neuropsychological manifestations may help to distinguish among different clinical and etiological types of pCA, and to elucidate the pathophysiology of a syndrome that has been associated with conditions as diverse as Alzheimer's disease, subcortical gliosis, and prion diseases. The parameters described in our case may thus help to address these issues in clinico-pathological studies with large numbers of patients with pCA.

Aged↗
PubMedDate not supplied

Pure agraphia following periendarterectomy stroke.

We report on a patient with pure agraphia due to perioperative stroke following left carotid endarterectomy. Her writing was illegible, slow and laborious, with impaired copying. Her oral spelling skills were normal. There was no limb apraxia. The CT brain scan revealed two hypodense areas--one anterior, the other posterior--at the level of the left centrum semi-ovale.

Aged↗