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[A case of multiple sclerosis with pure alexia]
J Shiota1, K Sugita, S Kikushima
1Department of Neurology, Showa University School of Medicine, Tokyo, Japan.
No to Shinkei = Brain and Nerve
|October 1, 1989
Summary
This case study details a young male with multiple sclerosis (MS) who experienced pure alexia, a rare reading disorder. Lesions in the brain
Area of Science:
- Neuroscience
- Neurology
- Clinical Case Study
Background:
- Multiple Sclerosis (MS) is typically characterized by white matter lesions, often not causing significant aphasia due to their small size.
- Pure alexia, the inability to read despite preserved writing ability, is an uncommon presentation in neurological disorders.
Observation:
- A 28-year-old male medical student presented with sudden onset of pure alexia, initially without other neurological deficits.
- Subsequent symptoms included transient right homonymous hemianopsia, headache, ataxia, and eventually left hemiplegia and convulsions.
- Neuropsychological evaluation confirmed paralexia with normal intelligence, writing, speech, and auditory comprehension.
Findings:
- Brain imaging (CT and MRI) revealed multiple white matter lesions, including in the left occipital lobe, consistent with MS.
- Corticosteroid therapy led to the resolution of headaches, ataxia, and radiographic abnormalities.
- The patient's presentation of pure alexia in the context of MS challenges the notion that MS lesions rarely cause such specific language deficits.
Implications:
- This case highlights that multiple sclerosis can manifest with rare neurological symptoms like pure alexia, even with small white matter lesions.
- The findings suggest a need to consider MS in the differential diagnosis of pure alexia, particularly in younger adults.
- Further research may explore the specific mechanisms by which MS lesions, even if small, can lead to complex cognitive deficits like alexia.