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Left hemiparalexia

Department of Neurology, The Neurological Institute, Columbia Presbyterian Medical Center, New York, NY (Drs. Binder, Tatemichi, Mohr, and Desmond, and K.A. Ciecierski)
Department of Neurology, SUNY-Health Science Center at Brooklyn, New York, NY (Dr. Lazar).

Three patients with left splenial lesions made paralexic errors restricted to the left end of words. Errors appeared more frequently when a correct response was highly dependent on the initial letter of the stimulus. One patient had full visual fields with hemialexia affecting the left visual field. The other two patients had complete right hemianopia. We attribute left-sided reading errors in the hemianopic patients to a retinotopically restricted disconnection pattern that selectively disrupts transfer of information originating from the peripheral left visual field. Functional resistance of the more numerous transcallosal projections representing visual field adjacent to the vertical meridian may account for such a pattern. The emergence of positional reading errors from retinotopically restricted left hemifield disconnection suggests that callosal information transfer during normal reading may primarily involve elemental sensory rather than lexical/semantic information.

Address correspondence and reprint requests to Dr. J.R. Binder, The Neurological Institute, 710 West 168th Street, New York, NY 10032.

Supported by NINDS Clinical Neurology Training Program Grant T32NS07155–13 and in part by Grant RO1-NS26179.

Received June 7, 1991. Accepted for publication in final form August 7, 1991.

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