1/14. rehabilitation outcome in a patient awakened from prolonged coma.BACKGROUND: This article describes the rehabilitation of a patient recovering from a prolonged coma (defined as lasting longer than 4 weeks). The case is noteworthy because it exemplifies the possibilities and difficulties entailed in treating these patients, who are often regarded as too severely impaired to justify intensive rehabilitation efforts. CASE REPORT: The patient is a 28-year old Polish male, unmarried, who suffered serious closed head injuries in an automobile accident in April of 1999. He was in a comatose state for more than two months, with a GCS score of 5. When admitted for rehabilitation he was bedridden, with global aphasia, agraphia, limb apraxia, and executive dysfunction. The rehabilitation program developed for him is described in detail. RESULTS: Over the course of rehabilitation, which began in December 1999 and continues to this writing, the patient has regained locomotion capabilities (though with impairments), and his speech has improved considerably. The apraxia has largely resolved, and he is able to write his name and copy words. He is now capable of performing many activities of daily living. CONCLUSIONS: A comprehensive program of rehabilitation characterized by a strategic, heuristic approach is capable of achieving a good outcome even in very difficult cases, such as prolonged coma.- - - - - - - - - - ranking = 1keywords = agraphia (Clic here for more details about this article) |
2/14. Discrepant oral and written spelling after left hemisphere tumour.Repetition, reading, confrontation naming, and oral and written spelling were studied in a 57 year-old man with a left hemisphere tumour. These tasks were repeated over a period of two weeks when the patient was being treated for brain oedema prior and subsequent to neurosurgical intervention. In the context of intact repetition and good reading, the most striking finding was a significant qualitative and quantitative discrepancy between oral and written spelling, with the latter task more severely affected. The pattern on oral spelling was that of lexical (or surface) agraphia. On written output, however, orthographic errors predominated. The relatively greater impairment of written spelling was not secondary to a motoric or visuo-spatial deficit. The observed patterns are not easily accommodated by current models of writing.- - - - - - - - - - ranking = 1keywords = agraphia (Clic here for more details about this article) |
3/14. Selective lower-case letter ideational dysgraphia.A case study of a man with a selective ideational dysgraphia for lower-case letters is described. His spelling skills were only very mildly impaired and there was no evidence of other praxic or visuoconstructional impairments. The findings are discussed in the context of information processing models. It is suggested that the representation of upper- and lower-case letters must be fairly independent.- - - - - - - - - - ranking = 4.3272051841052keywords = dysgraphia (Clic here for more details about this article) |
4/14. Right unilateral jargonagraphia as a symptom of callosal disconnection.We report the case of a right-handed patient who exhibited right unilateral jargonagraphia after a traumatic callosal hemorrhage. The lesions involved the entire corpus callosum, except for the lower part of the genu and the splenium. The patient's right unilateral jargonagraphia was characterized by neologisms and perseveration in kanji and kana, and was more prominent in kana than kanji. The jargonagraphia was similar to that observed in crossed aphasia, except that agraphia occurred only with the right hand. The patient also showed right unilateral tactile anomia and right tactile alexia, along with right-ear extinction on a dichotic listening test for verbal stimuli, which suggested that language function was lateralized to the right hemisphere. Since this patient had learned to write with his right hand, kinesthetic images of characters were thought to be formed and stored dominantly in the left hemisphere. We suggest that the callosal lesions disturbed the interhemispheric transfer of information for the dual-route procedures for writing in the right hemisphere, allowing the kinesthetic images of characters stored in the left hemisphere to be processed freely, resulting in the right unilateral jargonagraphia. At least two factors seem to explain that kana was more defective than kanji. First, writing in kana, which is assumed to be processed mainly via a sub-word phoneme to grapheme conversion route, might depend more strongly on lateralized linguistic processing than writing in kanji. Second, kanji, which represent meaning as well as phonology, with much more complicated graphic patterns than kana, are assumed to be processed in both hemispheres.- - - - - - - - - - ranking = 9keywords = agraphia (Clic here for more details about this article) |
5/14. Recognizing orally spelled words: an analysis of procedures shared with reading and spelling.Some investigators have suggested that recognizing orally spelled words is dependent on the same procedures ordinarily used in spelling, whereas others have viewed it either as dependent on reading procedures or as an independent ability. In the present study, a single subject with dyslexia and dysgraphia was examined on parallel tests of recognizing orally spelled words, reading, and spelling (writing), and a comparison was made of his performance on the three tasks. On both words and nonwords, the patient's errors in recognizing orally spelled words and in reading were alike, whereas his spelling errors were often different. The distinction between recognizing orally spelled words and spelling was further shown by his inability to recognize a set of orally spelled words that he could write correctly to dictation or on the basis of word meaning. These findings suggest that the procedures normally used for reading can accept sequences of letter identities as input when orally spelled words must be recognized.- - - - - - - - - - ranking = 0.86544103682104keywords = dysgraphia (Clic here for more details about this article) |
6/14. Variation in the pattern of omissions and substitutions of grammatical morphemes in the spontaneous speech of so-called agrammatic patients.We describe the patterns of omissions (and substitutions) of freestanding grammatical morphemes and the patterns of substitutions of bound grammatical morphemes in 20 so-called agrammatic patients. Extreme variation was observed in the patterns of omissions and substitutions of grammatical morphemes, both in terms of the distribution of errors for different grammatical morphemes as well as in terms of the distribution of omissions versus substitutions. Results are discussed in the context of current debates concerning the possibility of a theoretically motivated distinction between the clinical categories of agrammatism and paragrammatism and, more generally, concerning the theoretical usefulness of any clinical category. The conclusion is reached that the observed heterogeneity in the production of grammatical morphemes among putatively agrammatic patients renders the clinical category of agrammatism, and by extension all other clinical categories from the classical classification scheme (e.g., Broca's aphasia, wernicke's aphasia, and so forth) to more recent classificatory attempts (e.g., surface dyslexia, deep dysgraphia, and so forth), theoretically useless.- - - - - - - - - - ranking = 0.86544103682104keywords = dysgraphia (Clic here for more details about this article) |
7/14. Written spelling agraphia.When a disorder of single word writing is seen in conjunction with preserved oral spelling and intact written grapheme formation ("written spelling agraphia"), the deficit may be presumed to lie somewhere between letter choice and written motor output. Two potential deficits are considered: (1) visual letter codes are not activated properly and (2) the information contained within properly activated visual letter codes fails to reach intact graphic motor patterns. Two patients with written spelling agraphia were each given a series of tests aimed at distinguishing between the two possibilities. Results suggest that the written spelling agraphia seen in these two patients arises from different underlying deficits. The results are discussed in terms of the patients' CT scan lesion sites, which were markedly different.- - - - - - - - - - ranking = 7keywords = agraphia (Clic here for more details about this article) |
8/14. Patterns of dysgraphia and the nonlexical spelling process.This article evaluates the hypothesis that phoneme-grapheme conversion is accomplished by a passive activation device in which the selection of mapping options in the process of assembling orthography is determined by the frequency of usage of that option in the language. The spelling performance of two brain-damaged, acquired dysgraphic patients is interpreted as support for the stated hypothesis.- - - - - - - - - - ranking = 3.4617641472842keywords = dysgraphia (Clic here for more details about this article) |
9/14. Visual and phonological factors in acquired dysgraphia.The written spelling behaviour of a severely aphasic patient, whose many errors suggested a strong influence of visuo-spatial representations, is described. An experiment was carried out to confirm or refute the importance of visual factors in spelling to dictation. The strongest confirmatory evidence was the patient's propensity for writing the individual letters of a word in nonlinear order, i.e. not left to right, sometimes even beginning in the middle of a word. The influence of whole visual word-contours was also examined. Analysis of the results suggested that, in addition to the visual element, certain phonological factors played a small part in the patient's repertoire of strategies and this was confirmed in a second experiment. The patient's multi-strategy approach to written spelling is discussed on the basis of an information-flow model. This leads on to consideration of the possibility of consolidating the residual phonological system as part of a re-education plan.- - - - - - - - - - ranking = 3.4617641472842keywords = dysgraphia (Clic here for more details about this article) |
10/14. Neglect dysgraphia.A phonological dysgraphic syndrome is documented in a left handed man with a right-hemisphere lesion. His spelling was significantly affected by word length but neither word frequency nor the orthographical irregularity or word class proved to be relevant variables. Words were spelled equally efficiently forwards as backwards. A clear gradient of letter errors was shown to exist with letters on the left being mis-spelled more often than letters on the right of a word, irrespective of word length. These findings are discussed in terms of current models of spelling and their relevance to theories of unilateral neglect.- - - - - - - - - - ranking = 3.4617641472842keywords = dysgraphia (Clic here for more details about this article) |
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