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Right hemi-alexia.

Jason Js Barton1, Cristina Rubino2, Andrea Albonico1

  • 1Departments of Medicine (Neurology), Ophthalmology and Visual Science, University of British Columbia, Vancouver, Canada; Departments of Ophthalmology and Visual Science, University of British Columbia, Vancouver, Canada.

Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
|November 12, 2022
PubMed
Summary
This summary is machine-generated.

Right hemi-alexia, a rare reading disorder, is likely caused by intra-hemispheric disconnection. This case study demonstrates its existence and potential causes in visual word processing.

Keywords:
DisconnectionInferior longitudinal fasciculusPure alexiaReadingWords

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Area of Science:

  • Neuroscience
  • Cognitive Psychology
  • Neurolinguistics

Background:

  • Pure alexia was historically viewed as a disconnection syndrome.
  • Alternatively, it could stem from selective visual word agnosia due to damage to the visual word form area (VWFA).
  • Hemi-alexias are typically explained by disconnection, especially left hemi-alexia from splenial lesions impacting inter-hemispheric pathways.

Observation:

  • A rare case of right hemi-alexia is presented in patient PH, exhibiting severe reading deficits in the right visual field.
  • Despite a small hemi-scotoma, reading, lexical decisions, and perceptual discrimination of words, letters, and numbers were impaired in the right hemifield.
  • Object recognition remained intact, suggesting a specific deficit in visual word processing.

Findings:

  • Magnetic resonance imaging revealed a left lateral occipital meningioma with vasogenic edema affecting occipital white matter tracts.
  • Functional MRI indicated the VWFA was anterior to the tumor.
  • Post-surgical resection of the tumor led to the resolution of perceptual abnormalities.

Implications:

  • This case provides evidence for the existence of right hemi-alexia.
  • The findings suggest intra-hemispheric disconnection of occipital input to the VWFA as the most probable cause.
  • This challenges previous assumptions and deepens our understanding of visual word processing pathways.