Abstract
The case is reported of a patient with alexia and agraphia of kanji, and severe anomia after a subcortical hemorrhage in the right posterior inferior temporal area.
A 73-year-old right-handed man suddenly developed an inability to read letters. On admission to our hospital, his spontaneous speech was fluent without difficulties or paraphasias. Auditory comprehension was also preserved. However he could not name any objects. Kanji reading was remarkably poor and kanji writing was impaired spontaneously and from dictation. On the other hand kana reading and writing was generally good.
Detailed neuropsychological examination was performed in regard to naming and kanji reading abilities. The naming difficulty in the patient was found in visual and tactile sensory modalities. By contrast, he could name environmental sounds and his spontaneous word finding in conversation was preserved. We discussed the mechanism underlying the production of anomia, it is proposed that his naming difficulty could be interpreted as being caused by modality dependant naming disturbances.
As to alexia, he could not read aloud of kanji words, also was unable to match kanji words to pictures. Kinesthetic facilitation was not effective in kanji reading. But he was able to match auditorily presented words to kanji words. It seemed that a written kanji word failed to evoke an appropriate word image (phonological form and meaning) when it was presented visually.
These findings lead us to suggest that his alexia for kanji did not seem to be the so-called asymbolic type of alexia, because he could evoke the images of the letters in some channel. We further discussed kanji alexia with relation to naming difficulty.
