Types Of Central Alexia A Pure Alexia

The syndrome of pure alexia was first described in the 19th century. The most striking feature of this reading disorder is that the patient retains the ability to write and spell; thus, pure alexia is also known as alexia without agraphia. Patients who have alexia without agraphia cannot read that which they have just written.

A characteristic feature of pure alexia is that patients with this form of alexia retain the ability to recognize words that are spelled aloud to them. That is, although patients with pure alexia have difficulty recognizing written words, they do not have difficulty identifying those same words upon hearing the names of the letters in the word in serial order. In fact, many of these patients discover that they can "read" written words if they name the letters of the words. The use of this compensatory reading strategy has been termed letter-by-letter reading. The ability to identify letters may be impaired early in the course of pure alexia. However, letter-naming ability often recovers over time, or it can be successfully retrained in most cases. The error most likely to be produced is the orthographic paralexia. These errors may be the result of incorrect letter naming or failure to hold on to all letter names in a word while the word is being identified (Table II).

Table II

Central Alexias and Their Characteristic Paralexias

Table II

Central Alexias and Their Characteristic Paralexias

Alexia type

Paralexias

Pure alexia

Orthographic

Surface alexia

Orthographic

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