A single case study of 'herniplegid writing in a high level aphasicTnEscHEn, J. and FORD, F. (1937) Colloid cyst of the third ventricle. Archives of Neurology and WHcnn, R. (1974) Aphasia Screening Test (Whurr, London). WitLiRn, M. and LoncH, M. (1991) The use of a prosthesis to facilitate writing in aphasia and right herniplegid. Aphasiology, 5, 41 1-418. WtiLiRR, R., LORCH, M. and THREADGILL, L. (1990) The use of a prosthesis to facilitate writing in aphasia and right herniplegid. Fourth International Aphasia Rehabilitation Congress, Edinburgh. ZAIDEL, E. and SPEKKY, R. (1977) Some long-term motor effects of cerebral commissurotomy in man. Neuropsychologia, 15, 193-206. patient. B.Sc. thesis, National Hospitals College of Speech Sciences, London. Psychiatry, 37, 959-973.The Lorch paper reviews the theories proposed to account for hand differences in written productions after left hemisphere brain damage. Specifically, Lorch notes that several sources have reported (anecdotally) that when motor dysfunction of the right hand can be overcome with the aid of a prosthesis, right hand performances are 'linguistically superior' to left. The author states that the phenomenon, though described 20 years ago, has not been incorporated into treatment of agraphia, and that the reason for this lack is that there is no coherent theory to explain it. Her contention is then stated that application to treatment should be pursued without waiting for adequate theoretical explanation. However, she provides no evidence that attempts to overcome spasticity are not presently used in the treatment of agraphic cases, other than her statement that this is so. In addition, that this has occurred because of a lack of theoretic resolution is stated without data to support a causal relationship. In contrast, the review focuses exclusively on the question of why the left hand produces more linguistic errors than the right. That is, it addresses why the theories proposed thus far t o explain this phenomenon are not sufficient. Lorch's point that treatment application need not necessarily await complete theoretical explanation is valid, but it strikes me that the use of the prosthesis in treatment only addresses the fact that the spasticity is overcome, and no further theoretical explanation is necessary. The finding of linguistic differences between hands relates not to the use of the prosthesis, but instead to the lack of spasticity which masks the inherent but unexplained linguistic capabilities of the right hand in these patients. Therefore, use of the prosthesis in treatment should not wait for or be dependent on explanations of the linguistic