Yaguchi H, Bando M, Kubo T, Ohi M, Suzuki K
Department of Neurology, Tachikawa Medical Center, Yuyukenkoumura Hospital, Niigata, Japan.
Rinsho Shinkeigaku. 1998 Jun;38(6):499-505.
We reported a case of a 63-year-old right handed man with pure agraphia due to the left parietal lobe infarction. The characteristics of agraphia in the patient were as follows. 1) The written letters were generally recognizable and well formed. 2) He succeeded in pointing to single Kana letter named by the examiner from the Japanese syllabary, but missed in pointing to Kana words. 3) Further, it took more time for the patient to point to even single Kana letter than for the control. 4) Most errors in Kana writing was substitution. Errors in Kanji writing are partial lacking or no response. But his ability in Kanji writing was facilitated by visual cues. He was unable to describe the Hen (a left-hand radical) and Tsukuri (the body) of some Kanji letters and to name some Kanji letters when their Hen and Tsukuri were orally given. We classified pure agraphia into two types out of some references. In one type (Type 1), letters in writing are poorly formed, but the ability to make words with the methods other than writing, for example spelling with anagrams or typing are preserved. In another type (Type 2), letters in writing were well-formed, but spelling with anagrams or typing were abnormal. Type 1 agraphia could result from the only deficit of graphic motor engram, while type 2 agraphia could be caused by the deficits other than graphic motor engram. Agraphia in this case belongs to the type 2. The features of agraphia in this case suggested that his agraphia was caused by a disorder in recalling graphemes of letters, and in arranging at least of Kana-letters.
我们报告了一例63岁右利手男性因左侧顶叶梗死导致纯失写症的病例。该患者失写症的特点如下：1）书写的字母通常可辨认且形态良好。2）他能成功指出检查者从日语音节表中读出的单个假名，但指出假名单词时出错。3）此外，患者指出单个假名所花费的时间比对照组更长。4）假名书写中的大多数错误是替换。汉字书写错误是部分缺失或无反应。但视觉提示有助于他的汉字书写能力。他无法描述一些汉字的部首和主体，当口头给出一些汉字的部首和主体时，他也无法说出这些汉字。我们参考一些资料将纯失写症分为两种类型。在一种类型（1型）中，书写的字母形态不佳，但用书写以外的方法组词的能力，例如用变位词拼写或打字的能力保留。在另一种类型（2型）中，书写的字母形态良好，但用变位词拼写或打字异常。1型失写症可能仅由图形运动记忆痕迹的缺陷导致，而2型失写症可能由图形运动记忆痕迹以外的缺陷引起。该病例的失写症属于2型。该病例失写症的特征表明，他的失写症是由字母字形回忆障碍以及至少假名排列障碍引起的。
