Jónsdóttir M K, Magnússon T, Kjartansson O
Department of Rehabilitation, Reykjavík Hospital, Iceland.
Arch Neurol. 1998 Nov;55(11):1473-4. doi: 10.1001/archneur.55.11.1473.
To describe pure alexia and auditory comprehension problems in a young woman with multiple sclerosis (MS).
A 33-year-old woman with MS who complained of difficulties in reading and comprehending spoken language was referred for a neuropsychological examination. Reading difficulties were confirmed and most of the reading errors were additions, omissions, and substitutions of single letters. While the patient reported that the letters seemed to disappear before her eyes, no general problems with visual attention, visual discrimination, or scanning were detected. No difficulties with spelling were reported. The auditory comprehension deficit is interpreted as a form of a semantic access disorder and is not due to generalized slowing in information processing or conceptual disintegration.
Pure alexia is unusual in MS and to our knowledge only 1 other case has been reported (in Japanese). Memory impairments and slowed information processing are probably the most frequent cognitive sequelae of the disease and, consequently, the literature is biased toward the study of those cognitive domains. However, given the wide distribution of sclerotic plaques in MS, it could be argued that we should expect some variability of cognitive changes in MS. Striking deficits as seen in this patient should make us more sensitive to this possibility.
描述一名患有多发性硬化症（MS）的年轻女性的单纯性失读症及听觉理解问题。
一名33岁的MS女性患者，因抱怨阅读和理解口语存在困难而被转介进行神经心理学检查。阅读困难得到证实，大多数阅读错误为单个字母的添加、遗漏和替换。虽然患者报告字母似乎在她眼前消失，但未检测到视觉注意力、视觉辨别或扫视方面的一般问题。未报告拼写困难。听觉理解缺陷被解释为语义通达障碍的一种形式，并非由于信息处理普遍减慢或概念解体所致。
单纯性失读症在MS中并不常见，据我们所知，仅另有1例报道（日语）。记忆障碍和信息处理减慢可能是该疾病最常见的认知后遗症，因此，文献偏向于对这些认知领域的研究。然而，鉴于MS中硬化斑块分布广泛，可以认为我们应该预期MS患者认知变化存在一定变异性。该患者所见的显著缺陷应使我们对这种可能性更加敏感。
