Retraining in literal alexia: substitution of a right hemisphere perceptual strategy for impaired left hemispheric processing.

An adult patient with literal alexia, agraphia, slight anomia, and dyscalculia due to a left hemisphere infarct showed lack of sequential skills while pattern recognition remained intact. Some words were recognized as patterns, but could not be read phonetically. Therapy concentrated on forming an association of the visual pattern of the complete word with the retained auditory pattern. In this way the patient learned to read several hundred words and short phrases, even as anomia worsened. The patterns learned could not be generalized to noun declension or verb conjugation, or broken into smaller words. This learning process is characteristic of right hemispheric skills which were utilized as left hemispheric functions deteriorated.