Remediation of alexia without agraphia: a case study

Following a left temporoparietal-occipital haemorrhage and surgery, a 43-year-old, right-handed male exhibited alexia without agraphia. A remediation programme consisted of training in head turning to compensate for a right visual field defect, letter-by-letter reading aloud and covertly, drill with flash-cards to improve word recognition and practice in naming objects to improve dysnomia. The patient's reading improved markedly over a 6-week period and he was able to resume work as a respiratory therapy supervisor. A post-morbid depression resolved concomitantly with the patient's return to work. The training programme and the patient's post-training approach to reading are discussed in terms of hemispheric functioning as well as 'direct path' and 'indirect path' reading. The effectiveness of training is considered in the context of spontaneous recovery.