The Gogi (word-meaning) syndrome with impaired kanji processing: alexia with agraphia

Two cases, one with probable Pick's disease and one with herpes simplex encephalitis, are presented, focusing on Gogi (word-meaning) aphasia-like syndrome as their salient clinical feature. Their aphasic symptoms were characterized by impaired kanji processing and preserved kana processing in writing and oral reading known as a defining feature of Gogi aphasia, but little evidence of so-called "phonetic use of kanji in writing" and "confusion between on- and kun-readings of kanji in oral reading" often observed in Gogi aphasia. Systematic neuropsychological test batteries administered to them showed that the selective impairment of kanji processing did not always arise from a disturbance of a specific ability known to be essential to Gogi aphasia (i.e., failure in comprehending the semantic content of spoken and written language), but rather from an amnestic disruption in the ability to access the correct orthographic and phonological forms of kanji words. This selective impairment of kanji processing may be compatible with "alexia with agraphia of kanji," recently known to be attributable to left posterotemporal lesions. These results suggest that Gogi aphasia (or similar syndromes) is not necessarily a real syndrome but a polytypic constellation of symptoms.