Resolving metabolic abnormalities in a case of pure alexia.
We report resolving metabolic abnormalities corresponding to clinical improvement in a patient with pure alexia secondary to acute cerebral infarction. Local cerebral glucose metabolism (lCMRgl) was measured with positron emission tomography (PET) using 18F-fluorodeoxyglucose (18F-FDG) close to ictus and 4 1/2 months later. Serial CTs and a subsequent MRI demonstrated small, unchanging left-hemispheric lesions involving the area of the lateral geniculate body and the splenium of the corpus callosum. PET demonstrated the evolution of the metabolic abnormality resulting from intrahemispheric (lateral geniculate) and interhemispheric (splenium) disconnection in the absence of occipital lobe infarction. This case illustrates that cerebral disconnection can result in the syndrome of pure alexia. The factors accounting for focal hypometabolism in the absence of cerebral infarction are discussed.
Silver
F L
FL
Department of Neurology, University of Pennsylvania, Philadelphia 19104.
Chawluk
J B
JB
Bosley
T M
TM
Rosen
M
M
Dann
R
R
Sergott
R C
RC
Alavi
A
A
Reivich
M
M
D001921:Brain / Q000378:metabolism*; D002544:Cerebral Infarction / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism; D004411:Dyslexia, Acquired / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism*; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
D005947:Glucose