1/65. Treatment of a case of phonological alexia with agraphia using the Auditory Discrimination in Depth (ADD) program.Phonological alexia and agraphia are acquired disorders characterized by an impaired ability to convert graphemes to phonemes (alexia) or phonemes to graphemes (agraphia). These disorders result in phonological errors typified by adding, omitting, shifting, or repeating phonemes in words during reading or graphemes when spelling. In developmental dyslexia, similar phonological errors are believed to result from deficient phonological awareness, an oral language skill that manifests itself in the ability to notice, think about, or manipulate the individual sounds in words. The Auditory Discrimination in Depth (ADD) program has been reported to train phonological awareness in developmental dyslexia and dysgraphia. We used a multiple-probe design to evaluate the ADD program's effectiveness with a patient with a mild phonological alexia and mixed agraphia following a left hemisphere infarction. Large gains in phonological awareness, reading and spelling nonwords, and reading and spelling real words were demonstrated. A follow-up reassessment, 2 months posttreatment, found the patient had maintained treatment gains in phonological awareness and reading, and attained additional improvement in real word reading.- - - - - - - - - - ranking = 1keywords = alexia, dyslexia (Clic here for more details about this article) |
2/65. Selective uppercase dysgraphia with loss of visual imagery of letter forms: a window on the organization of graphomotor patterns.We report a patient who, after a left parieto-occipital lesion, showed alexia and selective dysgraphia for uppercase letters. He showed preserved oral spelling, associated with handwriting impairment in all written production; spontaneous writing, writing to dictation, real words, pseudowords, and single letters were affected. The great majority of errors were well-formed letter substitutions: most of them were located on the first position of each word, which the patient always wrote in uppercase (as he used to do before his illness). The patient also showed a complete inability to access the visual representation of letters. As demonstrated by a stroke segmentation analysis, letter substitutions followed a rule of graphomotor similarity. We propose that the patient's impairment was at the stage where selection of the specific graphomotor pattern for each letter is made and that the apparent selective disruption of capital case was due to a greater stroke similarity among letters belonging to the same case. We conclude that a visual format is necessary neither for spelling nor for handwriting.- - - - - - - - - - ranking = 0.11915227305447keywords = alexia (Clic here for more details about this article) |
3/65. Alexia caused by a fusiform or posterior inferior temporal lesion.We evaluated the alexia and agraphia of three patients with different lesions using Japanese kanji (morphograms) and kana (phonograms) and made a lesion-to-symptom analysis. Patient 1 (pure alexia for both kanji and kana and minor agraphia for kanji after a fusiform lesion) made more paragraphic errors for kanji, whereas patient 2 (alexia with agraphia for kanji after a posterior inferior temporal lesion) showed severe reading and writing disturbances and more agraphic errors for kanji. Brodmann Area 37 was affected in both patients, but in patient 2 the lesion was located lateral to that in patient 1. Patient 3 showed agraphia without alexia after restricted lesion to the angular gyrus. We believe that pure alexia (patient 1) results from a disconnection between the medial fusiform gyrus and posterior inferior temporal area (the lateral fusiform and inferior temporal gyri), whereas alexia with agraphia for kanji (patient 2), corresponding to lexical agraphia in Western countries, results from damage to the posterior inferior temporal area, in which whole-word images of words are thought to be stored. Furthermore, restricted lesion in the angular gyrus (patient 3) does not produce alexia; the alexic symptom of "angular" alexia with agraphia may be the result of damage to the adjacent lateral occipital gyri.- - - - - - - - - - ranking = 0.95321818443574keywords = alexia (Clic here for more details about this article) |
4/65. Cerebral localization of the center for reading and writing music.The mechanisms that underlie the ability to read and write music remain largely unclear compared to those involved in reading and writing language. We had the extremely rare opportunity to study the cerebral localization of the center for reading and writing music in the case of a professional trombonist. During rehearsal immediately before a concert, he suffered a hemorrhage that was localized to the left angular gyrus, the area that has long been known as the center for the ability to read and write. Detailed tests revealed that he showed symptoms of alexia with agraphia for both musical scores and language.- - - - - - - - - - ranking = 0.11915227305447keywords = alexia (Clic here for more details about this article) |
5/65. 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.- - - - - - - - - - ranking = 0.11915227305447keywords = alexia (Clic here for more details about this article) |
6/65. Word-centred neglect dyslexia: evidence from a new case.Neglect dyslexia resulting from damage to word-centred representations is extremely rare. We report on a new case. A left-handed subject, SVE, presented with aphasia and neglect dyslexia/dysgraphia following a right hemisphere stroke. In tachistoscopic reading tasks, some of his errors resulted from retina-centred neglect, as he responded more accurately to words flashed in the left visual field than to words flashed in the right visual field. However, the critical aspects of his reading performance indicated word-centred neglect. SVE incorrectly produced the initial elements of four-letter words, regardless of stimulus location (to the left and to the right of fixation, or at fixation), and orientation (horizontal and vertical presentation). A similar distribution of errors was demonstrated in writing (very inaccurate performance on initial letters). This pattern of performance suggests damage to an abstract letter string representation defined by spatial coordinates, rather than to an ordering mechanism. It is most naturally accommodated by models of word recognition which assume a word-centred level of representation, and cannot be explained by models which do not include such a representational level. Consideration of our subject in the light of other similar reports prompts hypotheses on the neural mechanisms involved in computing word-centred representations.- - - - - - - - - - ranking = 0.49780226585619keywords = dyslexia (Clic here for more details about this article) |
7/65. 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).- - - - - - - - - - ranking = 0.11915227305447keywords = alexia (Clic here for more details about this article) |
8/65. Surface dysgraphia in a regular orthography: apostrophe use by an Italian writer.The dual-route model of writing assumes two basic procedures involved in writing: lexical and non-lexical. The lexical route is fundamental in opaque orthographies such as English; from its impairment surface dysgraphia arises. Evidence for the role of a lexical route in transparent languages such as Italian, which have a regular orthography, has been more limited. We report a case study of ES, an Italian patient suffering from degenerative brain disease, who presented with a selective disorder of writing. He showed the unusual phenomenon of inserting an apostrophe inappropriately in the spellings of words. Neuropsychological evaluation provided evidence of loss of orthographic meaning of the apostrophe and a pattern of writing performance consistent with surface dysgraphia. There was also evidence of an accompanying surface dyslexia. We conclude that examination of apostrophe use provides a valuable means of detecting surface dysgraphia in the Italian language. The findings point to the need for cognitive models of writing to account for "dumb symbols" of language such as the apostrophe. This unique case provides a further example of the variety of clinical presentations of focal cerebral degeneration.- - - - - - - - - - ranking = 0.082967044309365keywords = dyslexia (Clic here for more details about this article) |
9/65. Semantic paralexias facilitated by tachistoscopic reading in a patient with impairment of phonological recoding.This study of a dyslexic patient supports the view that the level of impairment of the phonological route plays a role in the production of semantic paralexias. The patient's reading was based on a defective phoneme-to-grapheme transcoding, in spite of evidence that semantic information was available through non phonological routes. The hypothesis that the residual ability to carry out phonological recoding could block the production of semantic paralexias was confirmed by tachistoscopic reading, assumed to interfere with phonological recoding in this patient, that provoked a definite rise of this type of error. The relationship between the degree of damage of phonological route and the clinical expression of the syndromes of phonological dyslexia and deep dyslexia is also discussed.- - - - - - - - - - ranking = 0.88084772694553keywords = alexia, dyslexia (Clic here for more details about this article) |
10/65. 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.- - - - - - - - - - ranking = 0.59576136527234keywords = alexia (Clic here for more details about this article) |
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