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Phonological Agraphia After Superior Temporal Gyrus Infarction
Han-Joon Kim, MD;
Kon Chu, MD;
Kyoung-Min Lee, MD, PhD;
Dong Wook Kim, MD;
Seong-Ho Park, MD, PhD
Arch Neurol. 2002;59:1314-1316.
Background Phonological agraphia refers to a condition in which the ability to
write nonwords to dictation is impaired, while writing words to dictation
is preserved, as is oral repetition of the words and nonwords. This condition
has been regarded as reflecting a disconnection within the phonological writing
system, and previous neurolinguistic correlations suggested that the anterior-inferior
supramarginal gyrus was a crucial link within the system.
Setting A neurology department of a university hospital.
Patient A 51-year-old right-handed man presented with speech disturbances. On
initial evaluation of his language, his deficit was consistent with that of
conduction aphasia, which improved rapidly to an apparently normal level.
A subsequent detailed examination of oral and written repetition of words
and nonwords revealed a rather selective form of phonological agraphia. A
magnetic resonance imaging scan of his brain showed a focal ischemic lesion
at the left posterior superior temporal gyrus and at the underlying white
matter.
Conclusions In contrast to most previously described patients, this patient showed
a selective impairment of phonological agraphia in association with a focal
infarction restricted to the left posterior superior temporal gyrus, suggesting
that this region of the brain is an important node within a wider network
of areas that subserve the phonological route for writing.
From the Department of Neurology and the Clinical Research Institute,
Seoul National University Hospital, Neuroscience Research Institute of SNUMRC
(Drs H.-J. Kim, Chu, Lee, D. W. Kim, and Park), and the Department of Neurology,
Boramae City Hospital (Dr Park), Seoul, Korea.
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