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A case of literal alexia: evidence for a disconnection syndrome
Authors:S Sevush  K M Heilman
Institution:Veterans Administration Medical Center and University of Miami USA;Veterans Administration Medical Center and University of Florida College of Medicine USA
Abstract:We describe a patient with literal alexia, agraphia, and only minimal aphasia, resulting from a left occipito-parietal ischemic infarction. Neither impaired visual processing nor impaired oral output could explain the patient's letter reading deficit, since he retained the ability to match letters of mixed case, and remained able to spell aloud and to pronounce and comprehend orally spelled words. His residual word reading was characterized by better performance for nouns and highly imageable words than for functors , poorly imageable words, and nonwords. We propose that this patient's letter reading deficit was due to a partial disconnection of his visual from his linguistic systems, with residual word reading accomplished by a semantically mediated compensatory mechanism. We suggest, further, that the dissociations between word and letter reading observed in some alexic individuals may be attributed, in part, to a difference in the relative contributions of dorsal and ventral occipital structures to the reading process.
Keywords:Send requests for reprints to Steven Sevush  M  D    Neurology Service (127A)  Veterans Administration Medical Center  1201 NW 16th Street  Miami  FL 33125  
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