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A Case of Pure Agraphia in Kana following Left Parietal Lobe Hemorrhage Tsutomu FUJII 1 , Hiroshi MOTOYAMA 2,3 , Akinori SHIMIZU 4 , Masayoshi KURACHI 4 1Department of Psychiatry, Toyama Prefectural Central Hospital 2Department of Neurosurgery, Nagano Red cross Hospital 4Department of Neuropsychiatry, Faculty of Medicine, Toyama Medical and Pharmaceutical University Keyword: Pure agraphia , Phonological agraphia , Apraxic agraphia without apraxia , Parietal lobe hemorrhage , Kana pp.853-860
Published Date 1995/8/15
DOI https://doi.org/10.11477/mf.1405903934
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 A case of pure agraphia following left parietal lobe hemorrhage is reported. A 68-year-old right handed man was admitted on June 29, 1989, because of sudden incoherent speech. Several days after onset, his consciousness disturbance was cleared and neurological examination showed no abnormality.

 His intelligence and memory were fully preserved. Neither apraxia nor agnosia was present. Spontaneous speech, naming, repetition, and oral comprehension were not impaired. Reading comprehension and reading aloud were also well preserved. Difficulty was seen only in writing spontaneously and writing to dictation with both hands, whereas impairment in copying was not observed.

 He made errors selectively in kana-writing (kana characters are phonetic symbols for syllables), and rarely in kanji-writing (kanji characters are essentially non-phonetic logographic symbols). The majority of his writing errors consisted of substitution for another letter and insertion of an unsuitable letter into correct letter strings. Word construction with kana-letter cards was correctly performed. These findings are of the nature of phonological agraphia, in which phoneme-grapheme conversion is disturbed. On the other hand, his handwriting movement was not always smooth and he was confused about the pen-strokes in kana letters which resemble each other in form. These findings suggest that our patient has potentially the same dysfunction as apraxic agraphia, without apraxia which is characterized by the production of illegibly formed graphemes. CT lesion in our case was localized in the supramarginal gyrus, the anteroinferior portion of which is an important anatomical sub-strate for phonological agraphia, and the anterior angular gyrus, while the posterior angular gyrus and parietooccipital lobule, an important anatomical substrate for lexical agraphia, were spared.


Copyright © 1995, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-126X 印刷版ISSN 0488-1281 医学書院

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