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Ictal agraphia: a patient study

D L Schomer1, A Pegna, B Matton

  • 1Department of Neurology, Beth Israel Deaconess Medical Center, Harvard University, Boston, MA, USA.

Neurology
|March 4, 1998
PubMed
Summary
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We report a case of pure agraphia, a writing disorder, caused by focal seizures in the brain's parieto-occipital region. This highlights a rare neurological complication potentially linked to cyclosporine toxicity in transplant patients.

Area of Science:

  • Neuroscience
  • Neurology
  • Clinical Medicine

Background:

  • Pure agraphia is a specific writing disturbance characterized by the inability to write despite preserved language comprehension and spelling abilities.
  • It is typically associated with focal brain lesions, often in the left hemisphere's language network, or as a symptom within a broader confusional state.

Observation:

  • A case of pure agraphia was observed in a patient experiencing intermittent focal seizures originating from the left posterior parasagittal parieto-occipital region.
  • The patient had recently undergone a lung transplant and presented with elevated cyclosporine levels, placing them at risk for cyclosporine-induced neurotoxicity.

Findings:

  • The study identifies a direct link between focal seizures in the parieto-occipital cortex and the manifestation of pure agraphia.

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  • The findings suggest that cyclosporine toxicity, affecting the posterior cerebral vascular territory, may precipitate such neurological events and subsequent writing impairments.

    • Implications:

    • This case expands the known etiologies of pure agraphia, implicating intermittent focal seizures in a specific brain region.
    • It underscores the importance of considering cyclosporine neurotoxicity in transplant recipients presenting with transient neurological deficits, including agraphia.
    • Further research is warranted to elucidate the precise mechanisms linking cyclosporine levels, seizure activity, and specific cognitive impairments like agraphia.