Rehabilitation of pure alexia: A review

Abstract

Acquired reading problems caused by brain injury (alexia) are common, either as a part of an aphasic syndrome, or as an isolated symptom. In pure alexia, reading is impaired while other language functions, including writing, are spared. Being in many ways a simple syndrome, one would think that pure alexia was an easy target for rehabilitation efforts. We review the literature on rehabilitation of pure alexia from 1990 to the present, and find that patients differ widely on several dimensions, such as alexia severity and associated deficits. Many patients reported to have pure alexia in the reviewed studies, have associated deficits such as agraphia or aphasia and thus do not strictly conform to the diagnosis. Few studies report clear and generalisable effects of training, none report control data, and in many cases the reported findings are not supported by statistics. We can, however, tentatively conclude that Multiple Oral Re-reading techniques may have some effect in mild pure alexia where diminished reading speed is the main problem, while Tacile-Kinesthetic training may improve letter identification in more severe cases of alexia. There is, however, still a great need for well-designed and controlled studies of rehabilitation of pure alexia.

Pure alexia after right temporo-occipital hemorrhage in a right-handed female

“…Bu lezyonlar daha çok sol oksipital lob veya iki hemisfer arasındaki bağlantıyı sağlayan komissural liflerin yer aldığı korpus kallozum splenium bölgesinde yer alır (3)(4)(5)(6). Okumada görevli bir asosiasyon merkezi olan sol angüler girus ve oksipital lob arasındaki iletiyi bozan küçük bir lezyon da agrafisiz aleksiye yol açabilir (7,8).…”

“…Altta yatan nedene yönelik tedavilere ilaveten semptomatik tedavide klinik öneri olarak, taktil-kinestetik eğitim metodu, şiddetli aleksisi olan hastaların tedavisi için seçenek olabileceği gibi daha hafif aleksili vakalarda re-reading tekniğinden yararlanılabilir (5). Bizim vakamızda ise iki ay gibi kısa bir süre içinde hastanın şikayetleri tamamen düzeldiği için aleksiye yönelik rehabilitasyon sürecine gerek duyulmamıştır.…”

“…Sağ oksipital lob ile sol parietal lob arasındaki iletişimi kesecek şekilde, sol oksipital lob veya korpus kallozumun spleniumda yer alan lezyonlar bu hastalarda en sık karşılaşılan lokalizasyonlardır (3)(4). Dejerine'in 1892 yılında agrafisiz aleksi tanımından sonra bu sendrom için pür aleksi, global aleksi gibi birçok isim kullanılmıştır (5). Sağ hemisferle ilişkili agrafisiz alexi vakalarının nadir görülmesi ve kısa bir süre içinde klinik bulguların düzelmesi nedeniyle olgumuz bildirilmeye değer bulunmuştur.…”

The neuropsychological rehabilitation of visual agnosia and Balint’s syndrome

“…Figure 1 shows the steps followed during the literature search (PRISMA flow diagram; Moher, Liberati, Tetzlaff, Altman & The PRISMA Group 2009). Exclusion criteria were: (a) if the deficit was caused by a congenital condition, meaning the visual system had not developed normally before the occurrence of the impairment; (b) if the rehabilitation was on pure alexia as there have been publications reviewing the current status of rehabilitation (e.g., Starrfelt, Ólafsdóttir, & Arendt, 2013); if the sections dealing with the rehabilitation of visual agnosia and Balint's syndrome only did so by describing other researchers' work. We included studies: (a) providing evidence about the effectiveness of a rehabilitation by empirically evaluating it; (b) giving recommendations for rehabilitation based on scientific foundations or clinical experience as long as the recommendations were specific enough to give guidance to practising clinicians; (c) describing the impairment as part of a more global deficit or in conjunction with other impairments (as we expected the literature to be too scarce to only consider "pure" impairments); and (d) investigating cases in which neurodegenerative disorders gave rise to visual agnosia or Balint's syndrome.…”

The Aspect of Neurocognitive and Rehabilitation on Alexia Without Agraphia Case

“…Pure alexia without agraphia is diagnosed based on the form of reading ability disruption which contradicts with patient's writing ability remains normal. Neurocognitive analysis on alexia without agraphia based on clinical performance is delivered to anticipate the lag of conducting proper rehabilitation [7]. The following report is a case of pure alexia without agraphia from the perspective of neurocognitive and recovery analyses aspects which should be considered as necessary on aphasia syndrome.…”