Vol 48, No 5 (2014)

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Pure alexia after damage to the right fusiform gyrus in a right-handed male

Marcin Leśniak1, Paweł Soluch2, Urszula Stępień1, Wojciech Czepiel1, Joanna Seniów1
DOI: 10.1016/j.pjnns.2014.09.003
Neurol Neurochir Pol 2014;48(5):373-377.

Abstract

Pure alexia refers to a rare acquired reading disorder commonly associated with damage to the posterior part of the left medial occipito-temporal (fusiform) gyrus, which is known as the visual word-form area (VWFA) and thought to be the neural basis for visual processing of letters and words. Right-sided lesions very rarely lead to pure alexia in right-handed individuals. We report a case of a 33-year-old right-handed man with isolated pure alexia resulting from a hemorrhagic lesion to the right fusiform gyrus. A limited recovery of reading skills was observed within six weeks post onset. During this period, the patient spontaneously developed a letter-by-letter reading strategy. Functional magnetic resonance imaging revealed right-hemisphere dominance for language as well as bilateral reading-related activity in the fusiform gyri. Our case indicates that pure alexia may arise as a consequence of damage to the right fusiform gyrus even in right-handed patients (who still may have right hemisphere dominance for language and reading skills), and may lead to a severe reading disorder, as in individuals with left-hemisphere dominance for language.

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Neurologia i Neurochirurgia Polska