[A case of alexia with agraphia following left occipital lobe]

Since Dejerine reported cases of alexia with agraphia in 1891 and of pure alexia in 1892, it is generally said that the former may occur due to the lesion of the left angular gyrus and the latter due to that of the medial inferior area of the left occipital lobe. In this article, we reported a case of alexia with agraphia who had the main lesion in the medial inferior area of the occipital lobe of the left hemisphere. A 62-year-old right-handed male showed alexia with agraphia. CT scan and single photon emission CT revealed the main lesion in the medial occipital area on the left side. Alexia with agraphia of the patient was characterized as follows: with regard to reading, though his recognition of forms as letter was nearly spared, he could neither read letters or words nor differentiate Kana- from Kanji-letters. Paralexic errors included confusion of Kana and Kanji. He manifested no kinesthetic facilitation in reading. Regarding writing, his disturbances were more severe in Kanji-writing, but there were paragraphia and difficulty of letter-form evocation even in Kana-writing. He could not write spontaneously or to dictation. His copying of letters was also disturbed. Since it is said that there is no difference between Kana- and Kanji-disturbance in Japanese pure alexics, an aspect of alexia of the patient may be common to pure alexia.(ABSTRACT TRUNCATED AT 250 WORDS)