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November 1984

Pure Alexia Without Hemianopia

Author Affiliations

Department of Clinical Neurological Sciences University Hospital Saskatoon, Saskatchewan, Canada S7N 0X0

Arch Neurol. 1984;41(11):1130. doi:10.1001/archneur.1984.04050220024007

To the Editor.  —The usual presentation of pure alexia without hemianopia was discussed by Castro-Caldas and Salgado.1 We report a similar case.

Report of a Case.  —A 64-year-old man with metastatic colon cancer complained of a two-month history of difficulty in reading and headaches. Examination showed papilledema and pure alexia. He was unable to read but wrote fluently to dictation. Previously misread words were easily identified when spelled aloud. There was some difficulty in naming colors but not in matching them. The results of ophthalmologic examination, including Goldmann perimetry, were normal. There was no monochromatism. A computed tomographic scan showed two metastases, one in the right frontal lobe and the other in the left occipitotemporal region (Figure).

Comment.  —Pure alexia is caused by disconnection between the visual centers and Wernicke's area and is usually associated with right hemianophia.2

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