title: Pure alexia after damage to the right fusiform gyrus in a right-handed male.
abstract: Pure alexia refers to a rare acquired reading disorder commonly associated with damage to the posterior part of the left medial occipito-temporal (fusiform) gyrus, which is known as the visual word-form area (VWFA) and thought to be the neural basis for visual processing of letters and words. Right-sided lesions very rarely lead to pure alexia in right-handed individuals. We report a case of a 33-year-old right-handed man with isolated pure alexia resulting from a hemorrhagic lesion to the right fusiform gyrus. A limited recovery of reading skills was observed within six weeks post onset. During this period, the patient spontaneously developed a letter-by-letter reading strategy. Functional magnetic resonance imaging revealed right-hemisphere dominance for language as well as bilateral reading-related activity in the fusiform gyri. Our case indicates that pure alexia may arise as a consequence of damage to the right fusiform gyrus even in right-handed patients (who still may have right hemisphere dominance for language and reading skills), and may lead to a severe reading disorder, as in individuals with left-hemisphere dominance for language.
authors.affiliation: 2(nd) Department of Neurology, Institute of Psychiatry & Neurology, Warsaw, Poland. Electronic address: lesniak@ipin.edu.pl.
authors.forename: Marcin
authors.initials: M
authors.lastname: Leśniak
authors.affiliation: Institute of Sensory Analysis, Warsaw, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Soluch
authors.affiliation: 2(nd) Department of Neurology, Institute of Psychiatry & Neurology, Warsaw, Poland.
authors.forename: Urszula
authors.initials: U
authors.lastname: Stępień
authors.affiliation: 2(nd) Department of Neurology, Institute of Psychiatry & Neurology, Warsaw, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Czepiel
authors.affiliation: 2(nd) Department of Neurology, Institute of Psychiatry & Neurology, Warsaw, Poland.
authors.forename: Joanna
authors.initials: J
authors.lastname: Seniów
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D004410:Dyslexia / Q000150:complications* / Q000473:pathology*; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013702:Temporal Lobe / Q000473:pathology*
keywords: Functional magnetic resonance imaging; Fusiform gyrus; Hemorrhagic stroke; Laterality; Pure alexia