1/8. Chronological progression of a language deficit appearing to be postictally reversible in a patient with symptomatic localization-related epilepsy.A language deficit occurring interictally, with chronological progression, and postictally in a patient with symptomatic localization-related epilepsy, which began at 1.6 years of age, is reported. The patient was a 30-year-old right-handed man whose seizures seemed to originate from the left frontal lobe and to involve the left temporal lobe. The deficit in oral language consisted mainly of features of motor aphasia, including delayed initiation of speech with great effort, echolalic and palilalic tendencies, and word-finding difficulty, but he also showed features of sensory aphasia. Written language had agraphia observed in sensory aphasia, including well-formed letters, paraphasias, neologisms, and paragrammatism. Postictally, the language deficit appeared to be superficially reversible, and evolved from mutism through non-fluent jargon to the interictal level of language. Analysis of the patient's diaries from 10 to 26 years of age disclosed chronologically progressive deterioration of language with paragrammatism, showing an increase of grammatical errors, neologismus, literal and verbal paraphasias and misconstruction of sentences. The results suggest that localization-related epilepsy of presumably left frontal lobe origin causes not only a postictal language deficit but also a slowly progressive deficit of language function.- - - - - - - - - - ranking = 1keywords = agraphia (Clic here for more details about this article) |
2/8. Musical alexia for rhythm notation: a discrepancy between pitch and rhythm.In the process of reading music, the reading of rhythm and pitch might be differentiated, although there is no evidence of this to date. There have been cases of disorders restricted to the reading of pitch, but none in which the disorder has been restricted to the reading of rhythm. We present a case of musical alexia and agraphia with Wernicke's aphasia. An in-depth assessment of the subject's musical reading ability showed that her musical alexia was restricted to unfamiliar melodies. When a melody was divided into rhythm elements and pitch elements, pitch reading was preserved, but rhythm reading was severely disturbed. This is the first case reported of a disorder restricted to rhythm reading, and suggests the independence of rhythm reading and pitch reading.- - - - - - - - - - ranking = 1keywords = agraphia (Clic here for more details about this article) |
3/8. Unilateral right cerebral representation of reading in a familial left-hander.Several recent hypotheses of cerebral functional organization in natural left-handers hold that language, including reading, is localized either unilaterally in the left hemisphere or bilaterally, but not unilaterally in the right hemisphere. A case of alexia without agraphia in a left-hander with an infarct in the right occipital lobe and splenium of the corpus callosum is reported. That a permanent and complete alexia resulted from a single, right hemisphere lesion indicated that reading was completely lateralized to that hemisphere. The case demonstrates that in some natural left-handers language functions can be unilaterally represented in the right hemisphere.- - - - - - - - - - ranking = 1keywords = agraphia (Clic here for more details about this article) |
4/8. Apractic agraphia in a patient with normal praxis.Most right-handed crossed aphasics are not apractic. They usually have agraphia characterized by misspellings but retain the ability to write well-formed graphemes. We describe a right-handed patient with a right parietal lesion who was aphasic and not apractic. He was unable to write any formed graphemes despite a relatively preserved ability to spell aloud. We postulate that praxis and writing are dissociated in this patient because the motor engrams for praxis were located in his left hemisphere and the engrams for writing were in his right hemisphere. In addition, he comprehended commands for limb motor activities (praxis) far better than he comprehended other speech. This suggests that in this patient the areas used to comprehend limb motor commands may be anatomically distinct from areas important in comprehending other aspects of speech.- - - - - - - - - - ranking = 5keywords = agraphia (Clic here for more details about this article) |
5/8. aphasia in a prelingually deaf woman.A left parietal infarct in a prelingually deaf person resulted in an aphasia for both American sign language (ASL) and written and finger-spelled English. Originally the patient had a nearly global aphasia affecting all language systems. By five to seven weeks post-onset her symptoms resembled those of hearing aphasics with posterior lesions: fluent but paraphasic signing, anomia, impaired comprehension and repetition, alexia, and agraphia with elements of neologistic jargon. In addition, there was a pronounced sequential movement copying disorder, reduced short-term verbal memory and acalculia. In general, the patient's sign errors showed a consistent disruption in the structure of ASL signs which parallels the speech errors of oral aphasic patients. We conclude that most aphasic symptoms are not modality-dependent, but rather reflect a disruption of linguistic processes common to all human languages. This case confirms the importance of the left hemisphere in the processing of sign language. Furthermore, the results indicate that the left supramarginal and angular gyri are necessary substrates for the comprehension of visual/gestural languages.- - - - - - - - - - ranking = 1keywords = agraphia (Clic here for more details about this article) |
6/8. Alexia and agraphia in Wernicke's aphasia.Three patients with otherwise typical Wernicke's aphasia showed consistently greater impairment of reading than auditory comprehension. While this syndrome resembles alexia with agraphia, the paraphasia of speech, repetition, and naming underline the aphasic nature of the disorder. Together with previous reports of isolated word deafness in Wernicke's aphasia, these cases suggest a relative independence of auditory and visual language processing.- - - - - - - - - - ranking = 5keywords = agraphia (Clic here for more details about this article) |
7/8. music and language: musical alexia and agraphia.Two aphasic right-handed professional musicians with left hemispheric lesions had disturbed musical function, especially musical alexia and agraphia. In Case 1 aphasia was of transcortical sensory type, with severe agraphia and decreased comprehension of written words, although she could match them with pictures. Except for reading and writing, musical ability was normal; she could sing in five languages. Musical alexia and agraphia affected pitch symbols more than rhythm. Case 2 had conduction aphasia and severe expressive amusia, especially for rhythm. Although his language alexia and agraphia were milder than Case 1's, his musical alexia and agraphia were more severe, affecting rhythm as much as pitch. In neither patient were those aspects of musical notation either closest to verbal language or most dependent upon temporal (sequential) processing maximally impaired. These cases are consistent with the literature in suggesting that the presence or absence of aphasia or of right or left hemispheric damage fails to predict the presence, type, or severity of amusia, including musical alexia and agraphia. The popular notion that receptive amusia follows lesions of the language-dominant temporal lobe, whereas expressive amusia follows non-dominant frontal lobe damage, is an over-simplification, as is the view that increasing musical sophistication causes a shift of musical processing from the right hemisphere to the left.- - - - - - - - - - ranking = 10keywords = agraphia (Clic here for more details about this article) |
8/8. Jargonagraphia in Kanji and Kana in a Japanese crossed Wernicke's aphasic.A right-handed Japanese crossed Wernicke's aphasic showed complete neologistic jargonagraphia in kanji and kana with anosognosia of his writing deficits. Prominent jargonagraphia in kanji is quite rare and has not been previously described in the literature. Marked dissociation between speaking and writing during the course suggested that his jargonagraphia might be unique to crossed aphasia. His condition was interpreted for the main part by Yokoyama, Okubo, Doseki, and Yamadori's hypothesis (1981) that free-running on of motor engrams of characters stored in the left hemisphere caused jargonagraphia in crossed aphasia. This case of jargonagraphia in kanji suggests that this hypothesis should be supplemented by the following points: (1) in kanji, not necessarily a character as a whole, but radicals or parts of radicals, function as motor units, which may be released to produce jargonagraphia in kanji; (2) free-running on of visual images as well as of kinesthetic images should be considered especially in written jargon in kanji.- - - - - - - - - - ranking = 10keywords = agraphia (Clic here for more details about this article) |