Alexia without agraphia associated with right occipital lesion

Area of Science:

• Neuroscience
• Neurology
• Clinical Neuroimaging

Background:

• Alexia without agraphia is a rare neurological condition characterized by the inability to read while preserving the ability to write.
• Typically, this syndrome is associated with lesions in the dominant left hemisphere, particularly the occipital-temporal region.

Observation:

• A 78-year-old right-handed male presented with alexia without agraphia following a thrombotic stroke.
• Neuroimaging revealed the stroke localized to the right occipital lobe.
• Cerebral dominance testing indicated right hemisphere dominance for language in this patient.

Findings:

• The patient's symptoms and lesion location (right occipital lobe) represent a unique case of alexia without agraphia.
• This case suggests that the right hemisphere can be dominant for language functions, leading to this syndrome after a lesion in this hemisphere.
• The findings challenge the long-held belief that the left hemisphere is exclusively dominant for reading and writing in right-handed individuals.

Implications:

• This case provides critical evidence for the potential for right-hemisphere language dominance and its role in alexia without agraphia.
• It necessitates a re-evaluation of neuroimaging and clinical assessments for language lateralization, especially in atypical cases.
• Further research is warranted to understand the neurobiological mechanisms underlying language processing in individuals with right-hemisphere dominance.