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February 1983

Reversible Alexia Without Agraphia due to Migraine

Author Affiliations

From the Department of Neurosciences, University of California San Diego Medical Center.

Arch Neurol. 1983;40(2):114-115. doi:10.1001/archneur.1983.04050020076017

Alexia without agraphia is caused by lesions that interrupt both right and left calcarine cortex outflow to the dominant angular gyrus.1 Déjerine's original case2 and most subsequent cases3,4 have resulted from infarction of the left posterior cerebral artery, but many other causes have been described.4-10 This report describes the first patient, to our knowledge, in whom alexia without agraphia developed following a transient right homonymous hemianopia during a migraine aura.

REPORT OF A CASE  A 35-year-old male internist experienced 20- to 30-minute episodes of right homonymous hemianopia twice in 1976 and once in 1979, followed each time by bifrontal, throbbing headaches lasting 12 to 24 hours. The last episode was followed by five minutes of numbness and decreased coordination of his right hand.In January 1981 a right homonymous hemianopia developed in the patient while he was waiting for a train after a sleepless 36-hour