Cases reported "Agraphia"

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11/213. A case of musical agraphia.

    Damage to the left upper parietal lobule causes pure agraphia. However, we experienced a patient who exhibited musical agraphia following such a lesion after the agraphia improved. The patient was a 53-year-old female piano teacher. After surgery, she exhibited agraphia and musical agraphia. There was no expressive amusia, receptive amusia, aphasia, agnosia or apraxia. Fifteen months post-surgery, when her agraphia had resolved, her abilities to read, write, and copy music were evaluated. She could read and write single notes and musical signs, but her ability to write a melody was seriously impaired. Furthermore, the salient impairment was in writing rhythm rather than pitch. She could copy music, but only slowly. We consider her a case of pure musical agraphia. ( info)

12/213. 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. ( info)

13/213. 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. ( info)

14/213. Serial order effects in spelling errors: evidence from two dysgraphic patients.

    This study reports data from two dysgraphic patients, TH and PB, whose errors in spelling most often occurred in the final part of words. The probability of making an error increased monotonically towards the end of words. Long words were affected more than short words, and performance was similar across different output modalities (writing, typing and oral spelling). This error performance was found despite the fact that both patients showed normal ability to repeat the same words orally and to access their full spelling in tasks that minimized the involvement of working memory. This pattern of performance locates their deficit to the mechanism that keeps graphemic representations active for further processing, and shows that the functioning of this mechanism is not controlled or "refreshed" by phonological (or articulatory) processes. Although the overall performance pattern is most consistent with a deficit to the graphemic buffer, the strong tendency for errors to occur at the ends of words is unlike many classic "graphemic buffer patients" whose errors predominantly occur at word-medial positions. The contrasting patterns are discussed in terms of different types of impairment to the graphemic buffer. ( info)

15/213. Superior written over spoken picture naming in a case of frontotemporal dementia.

    Two main hypotheses have been proposed regarding the role of phonology in written word production. According to the phonological mediation hypothesis, the retrieval of the lexical phonological representation of a word is an obligatory prerequisite to the retrieval of its spelling. Therefore, deficits to the phonological lexicon should affect both spoken and written picture naming. In contrast, the orthographic autonomy hypothesis posits that the lexical orthographic representations of words can be accessed without any necessary phonological mediation. In support of this view, cases of preserved written naming despite impaired lexical phonology have been reported following brain damage. In this report, we replicate this basic pattern of performance in case YP, a 60-year-old woman with a pattern of frontotemporal dementia. As her disease progressed, YP's ability to write down the names of pictures remained very good despite a severe decline in oral naming. Further testing indicated that this deficit was not primarily due to an articulatory or post-lexical phonological deficit. YP's case provides strong additional support for the orthographic autonomy hypothesis. The significance of this case with respect to the characterization of dementia syndromes is discussed. ( info)

16/213. Two different dysgraphic syndromes in a regular orthography, spanish.

    In opaque orthographies, such as English and French, three central dysgraphic syndromes have been described: surface dysgraphia, phonological dysgraphia, and deep dysgraphia. writing breakdown patterns reveal that spelling can proceed by phoneme-to-grapheme conversion, or by a more direct or lexical approach. Ardila et al. (1989, 1991) claim that for Spanish speakers a lexical strategy for reading and writing is not an option due to the regularity of the orthography of this language. In this study we report two clear cases of dysgraphia in Spanish, one of surface dysgraphia and another of phonological dysgraphia, where a dissociation between lexical and sublexical writing can be observed, thus contradicting Ardila's position. ( info)

17/213. 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. ( info)

18/213. Phonological agraphia following a focal anterior insulo-opercular infarction.

    Following a unique infarction, restricted to the left anterior insula and the adjacent part of the intrasylvian frontal opercular cortex, an 83-year-old right-handed patient acutely developed a severe speech disorder that evolved into mere mutism within a few hours. After rapid recovery from mutism, oral language was characterized by severe apraxia of speech. In-depth language investigations further disclosed an isolated, highly selective disturbance of the spelling system (phonological agraphia) which resolved rapidly. One year after onset of neurological symptoms, the apraxia of speech had almost completely receded. The anatomoclinical findings in this first representative of pure and nearly isolated phonological agraphia complement previous neuroanatomical and neurolinguistic accounts of phonological agraphia. The data not only seem to enrich current insights in the anatomical locus for phonological agraphia, they also seem to contribute to a further delineation of the insular role in phonologically mediated aphasic manifestations. ( info)

19/213. Pure Kana agraphia as a manifestation of graphemic buffer impairment.

    We report a left-handed man who demonstrated a pure agraphia limited to words written in Kana characters (syllabograms) following a right putaminal hemorrhage. writing words in Kanji characters (logograms) was well preserved. His performance in Kana writing was characterized by intact ability to write single syllables, error increase in the second half of words directly proportional to the word length and correct but slow writing of words using kana blocks. Errors were more prominent in Hiragana words than Katakana words which are usually used to transcribe foreign words. Acoustic-grapheme sequencing per se was not impaired as shown by his correct performance in arranging character blocks. These findings suggest selective damage to the graphemic buffer, a module that temporarily maintains the graphemic representation elaborated in previous stages before it is sent to the peripheral systems for its motor realization. ( info)

20/213. Jargonagraphia with severe aphasia due to a right hemisphere lesion: case report.

    The authors report a case of a patient who developed jargonagraphia, severe aphasia, unilateral spatial neglect and apraxia due to a right hemisphere lesion. Jargonagraphia with severe aphasia, unilateral spatial neglect and apraxia is quite rare. The mechanisms of jargonagraphia remain unknown. A possible mechanism underlying this case of jargonagraphia is discussed. ( info)
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