A second case of the thrid alexia in pure form

Randi Starrfelt, Anders Gade, Christian Gerlach, Hanne Udesen

    Abstract

    We present a patient (J.M.) with severe alexia and agraphia in the absence of aphasia, and with intact reading and writing of numbers. J.M., a right- handed 18-year-old man, presented with alexia and agraphia after concus- sion. CT and MR were normal. J.M. is impaired in identifying, writing, and copying letters. His reading and writing of numbers are normal, as is his written arithmetic. Object naming is within normal range, and his copy- ing and drawing of figures and objects are good. In a single letter identi- fication task, J.M. was able to identify only 13/29 uppercase letters and 18/29 lowercase letters. He is almost completely unable to read words, and we have not observed any whole-word reading. Rather, J.M. uses a slow and laborious letter-by-letter strategy when trying to read words, in- cluding his own name, and misidentification of letters is frequent. His nam- ing to oral spelling is good, as is his oral spelling of dictated words. In writing, letters are partly superimposed on each other, making the words virtually unreadable. There are no obvious spelling errors, but some letters are poorly formed. By contrast to his reading, J.M. was able to identify written numbers (1–7 digits) quickly and correctly. He is also able to write numbers and perform written calculations without difficulties. This pat- tern of performance closely resembles that described by Anderson, Dam- asio, & Damasio. Their patient, presumably the only one on record with this syndrome, had a lesion in Exner’s area in the left premotor cortex.
    Original languageEnglish
    JournalJournal of the International Neuropsychological Society
    Pages (from-to)398
    ISSN1355-6177
    Publication statusPublished - May 2000

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