[Agraphia of the left hand--its characteristics and mechanism of development]

We observed 62 y.o. right-handed woman, whose truncus of corps callosum was damaged by infarction of left anterior cerebral artery, that was verified by coronal CT scan finding. She was apraxic and agraphic only with left hand. We examined the characteristics of her unilateral left agraphia from the point of quantitative and qualitative views. These analysis seemed to reveal three main characteristics of unilateral left agraphia of this patient. These were as follows; 1) productive, 2) neographic and 3) iterative. Another important feature of this patient was the mute state during her left-hand writing. Her left agraphia could not explained by apraxic factor, because her copying capacity was remarkably preserved in comparison with her dictation or written naming ability. Furthermore, this agraphia was not aphasic because her right-hand writing was almost intact. We agreed with Yamadori who insisted that this type of agraphia was neither apraxic nor aphasic, but the particular third agraphia which was named as "disconnection agraphia". We considered that the mute state during her left-hand writing might some kind of transient aphasia, which may reflect the functional disturbance of left hemisphere, and the reduced energy in the left hemisphere could increase the activity of right hemisphere. Partial interhemispheric disconnection might induce transient "linguistic anosognosia" in this patient. We believe that these transient hyperactivity and transient linguistic anosognosia could generate above mentioned characteristics of her left agraphia; productive, neographic and iterative.