Sato M, Yasui N, Suzuki A, Kawamura S, Sayama I, Kobayashi T
No To Shinkei. 1983 Nov;35(11):1145-51.
A 45-year-old woman showed agraphia and decreasing spontaneity. She was diagnosed as Moyamoya disease by cerebral angiography. CT scans revealed the abnormal low density area in the left frontal lobe, and the regional cerebral blood flow study showed low perfusion in the bilateral frontal lobe and the left high convexity area. She could copy specimens of the author's writing, but her spontaneous writing and dictation were impaired with either hand. The form of each letter she wrote was not so distorted, but wrong letters were substituted for the correct ones. Errors in Kana-writing were more common than in Kanji. Although her spontaneous speech was diminished, auditory comprehension, reading and constructional abilities were unaffected. She exhibited no agnosia and apraxia. Agraphia in this case was caused by a disconnection between the visual image and auditory image and/or between the visual image and kinesthetic image. Inner speech (Luria, AR et al, 1968) in this case might be disturbed, and decreasing spontaneity and delay of response resulted from the frontal lesion. The writing process may be constituted of many factors; images of visual, auditory and kinesthetic as well as primary functions of sensory and motor. Furthermore, it may be necessary for normal writing that one's inner speech, activities and intention of writing behavior are intact.
一名45岁女性出现失写症且自发性降低。她通过脑血管造影被诊断为烟雾病。CT扫描显示左额叶有异常低密度区，区域脑血流研究显示双侧额叶和左大脑凸面区灌注不足。她能够临摹作者书写的样本，但用任何一只手进行自发性书写和听写都有障碍。她所写的每个字母的形态并没有严重变形，但存在用错误字母替代正确字母的情况。假名书写中的错误比汉字书写中更常见。虽然她的自发性言语减少，但听觉理解、阅读和构图能力未受影响。她没有表现出失认症和失用症。该病例中的失写症是由视觉图像与听觉图像之间和/或视觉图像与动觉图像之间的联系中断所致。该病例中的内部言语（卢里亚，AR等人，1968年）可能受到干扰，额叶病变导致自发性降低和反应延迟。书写过程可能由许多因素构成；视觉、听觉和动觉图像以及感觉和运动的基本功能。此外，书写行为的内部言语、活动和意图完整对于正常书写可能是必要的。
