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Ardila Agraphia
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64
Science
Graduate
03/05/2009

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Term
agraphia
Definition
a loss or impairment in the ability to produce wriiten language caused by brain pathology
Term
linguistic defects
Definition
aphasic agraphias
Term
non linguistic defects
Definition
(motor or spatial)
-(non aphasic agraphias
Term
agraphia history
Definition
-OGLE= (1867) introduced the term agraphia
-EXNER (1881) proposed a "writing center" (base of the second frontal gyrus, in front of the primary motor area of the hand)
-DEJERINE (1891) described the "alexia without agraphia' syndrome
-GERSTMAN (1940) proposed that agraphia can appear with acalculia, right-left disorientation, and finger agnosia in a single syndrome (Gerstman's or angular gyrus syndrome)
Term
CLASSIFICATION OF AGRAPHIAS

Aphasic Agraphias
Definition
-agraphia in Broca Aphasia
-agraphia in Wernicke Aphasia
-agraphia in Conduction Aphasia
-other Aphasic Agraphias
Term
CLASSIFICATION OF AGRAPHIAS

Non-aphasic agraphias
Definition
-motor agraphia
-paretic agraphia
-hypokinetic agraphia
-hyperkinetic agraphia
-other motor agraphias
Term
CLASSIFICATION OF AGRAPHIAS
Definition
-pure AGRAPHIA
-APRAXIC AGRAPHIA
-SPATIAL AGRAPHA
Term
CLASSIFICATION OF AGRAPHIAS

other writing disturbances
Definition
-hemiagraphia
-frontal writing disturbances
-confusional states
-psychogenic agraphia
Term
CLASSIFICATION OF AGRAPHIAS

PSYCHOLINGUISTIC CLASSIFICATION OF AGRAPHIAS

-central aphasias
Definition
-phonological agraphia
-lexical (surface) agraphia
-deep agraphia
Term
CLASSIFICATION OF AGRAPHIAS

PSYCHOLINGUISTIC CLASSIFICATION OF AGRAPHIAS

-peripheral aphasias
Definition
-spatial (afferent) agraphia
-apractic agraphia
Term
agraphia in Broca aphasia

-SPOKEN OUTPUT
Definition
-sparse output
-effortful
-poor articulation
-short sentences
-dysprosody
-agrammatism
-phonological paraphasias
Term
agraphia in Broca aphasia

-WRITTEN OUTPUT
Definition
-sparse output
-effortful
-clumsy calligraphy
-abbreviated input
-agrammatism
-literal paraphasias
Term
agraphia in Broca aphasia
Definition
-disorders in writing are clearly correlated with the fundamental linguistic defect
-writing is slow, clumsy, painstaking, short, and agrammatic
-literal paragraphias due to anticipations (take-> kake), preservations (take-> tate), and letter omissions, particularly in syllabic clusters (glass-> gass).
-calligraphy is poor
Term
agraphia in Broca aphasia
Definition
-right hemiparesis is usually observed, and the patient has to use his/her left hand in writing. this change implies an additional problem. writing difficulties, in consequence, are not the only result of the linguistic defects.
Term
agraphia in wernicke aphasia
Definition
-patients with wernicke ahasia present an impairmnt in writing ability characterized by a fluent writing, well-formed letters, contained in an inappropriate way.
Term
agraphia in wernicke aphasia
Definition
-literal paragraphias (additions, substitutions and omissions of letters), verbal and neologistic paragraphias are also found.
-written language deficit parallelizes the oral language defect
Term
agraphia in wernicke aphasia
Definition
-grammatical elements are observed frequently, these grammatical elements are overused

-sentences may lack clear limits; nouns may be under-represented, writing may be non understandable (jargonagraphia)
Term
agraphia in wernicke aphasia

SPOKEN OUTPUT
Definition
-normal ARTICULATION
-fluent
-normal phrase length
-normal prosody
-paragrammatism
-paraphasias
Term
agraphia in wernicke aphasia

WRITTEN OUTPUT
Definition
-normal calligraphy
-fluent
-normal sentence length
-paragrammatism
-paragraphias
Term
agraphia in conduction aphasia
Definition
-variable
-afferent motor agraphia (Luria)
-literal paragraphias
-self-corrections (conduit d' approach)
-apraxic agraphia
Term
agraphia in conduction aphasia
Definition
-spontaneous writing is superior to writing by dictation.
-literal paragraphias (substitutions, omissions and additions of letters) in complex phonological sequences, low frequency words and pseudowords.
-patient recognizes that the word is incorrectly written, but when attempting to correct it, new errors are observed. writing contain a significant number of corrections.
Term
agraphia in conduction aphasia
Definition
-patient may state that he/she knows the word (and even repeats it for him/herself) but cannot remember how to write it.
-writing is slow and difficult
-some ideomotor apraxia may exist, and even letters are poorly formed, even though in general they are recognizable
-sometimes an evident apraxic agraphia is found
Term
AGRAPHIA IN OTHER APHASIAS

-GLOBAL APHASIA
Definition
-severe defects in writing
Term
AGRAPHIA IN OTHER APHASIAS

MIXED EXTRASYLVIAN
Definition
-severe writing defects, but some ability to copy is preserved
Term
AGRAPHIA IN OTHER APHASIAS

EXTRASYLVIAN SENSORY APHASIAS
Definition
-verbal paragrahias, writing defect is variable depending upon the extension of the pathology to the parietal lobe
Term
AGRAPHIA IN OTHER APHASIAS

EXTRASYLVIAN MOTOR APHASIA
Definition
-inability to write, reading is better
Term
AGRAPHIA IN OTHER APHASIAS

ALEXIA WITH AGRAPHIA
Definition
-no writing, literal agraphia
Term
motor agraphia

-PARETIC AGRAPHA
Definition
-lower motor neuron (flaccidity)
-upper motor neuron (spasticity)
-large, poorly written latters
Term
motor agraphia

HYPOKINETIC AGRAPHIA
Definition
-parkinson's disease
-resting tumor
-micrographia
Term
motor agraphia

HYPERKINETIC AGRAPHIA
Definition
- huntington's disease
-cerebellar agraphia
Term
MOTOR AGRAPHIA
Definition
writers cramp
Term
PURE AGRAPHIA
Definition
-Exner (1881) proposed a "center for writing" (base of the second frontal gyrus, in front of the primary motor area of the hand)
-Dubois, Hecean & Marcie (1969) reported four cases of frontal "pure agraphia"
-some authors name the apraxic agraphia as pure agraphia
Term
APRAXIC AGRAPHIA
Definition
Term
apraxic agraphia
Definition
-kleist (1923) distinguished several types of apraxic agraphia (apraxia for holding the pencli, apraxia for writing texts, and apraxia for writing letters)

-goldteain (1984) refers to apractoamnesic agraphia

-Hecaen & albert (1978) apraxic agraphia feres to the inability to form graphemes

-Crary & Heilman (1988) apraxic agraphia can appear without other manifestations of ideomotor apraxia (pure agraphia)
Term
spatial agraphia
&
visuospatial agraphia
Definition
have been considered as a non aphasic writing disorder, resulting from visuospatial defects that impairs orientation and correct sequencing in writing
Term
spatial agraphia
&
visuospatial agraphia
Definition
a disturbance of graphic expression due to an impairment in visuospatial perception resulting from a lesion in the nonlanguage-dominant hemisphere
Term
spatial agraphia
characteristic:
Definition
1. some graphemes are produced frequently with one,two, or even more exra strokes
2. the lines of writing are not horizontal but slant at variable angles of inclination to the top or bottom of the page
3. writing occupies only the right-hand part of the paper;
4. blanks are inserted between graphemes that make up the word, disorganizing the word and destroying the unity
Term
spatial agraphia
Definition
it is a consequence of:
1-left hemi-spatial neglect
2-constructional difficulties in writing
3-general spatial defects
4-some motor disautomatization and tendency to perseverate
Term
spatial agraphia
Definition
usually associated with spatial alexia, spatial acalculia, left hemi-spatial neglect, constructional apraxia, and general spatial difficulties
Term
spatial agraphia
Definition
some degree of spatial agaraphis is observed in about 75% of the patients with right retro-rolandic lesions, and about 50% of the patients with right pre-rolandic lesions
Term
hemiagraphia
Definition
split brain-syndrome
Term
prefrontal writing disturbances
Definition
agraphia without alexia
-dysexecutive agraphia
Term
araphia in confusional states
Definition
difficulties in writing
Term
hypergraphia
Definition
temporal lobe epilepsy
Term
psychogenic agraphia
Definition
hysterical agraphia
Term
aphasic agraphias
Definition
classified according to the basic language disorder associated with agraphia:
-agraphia in Broca aphasia (non-fluent agraphia), agraphia in Wernicke aphasia (fluent agraphia)
Term
central agraphia
Definition
-lexical (surface) agraphia
-phonological agraphia
-deep agraphia
Term
non-aphasic agraphias
Definition
-motor agraphia
-spatial agraphia
-apraxic agraphia
Term
peripheral agraphias
Definition
spatial (afferent) agraphia
-apraxic agraphia
Term
central agraphias
(dysgraphias)
Definition
-affect one or more of the processes involved in the spelling of familiar and non familiar words (and pseudowords)
Term
central agraphias
(dysgraphias)
Definition
affect spelling in all ways; handwriting, typing, oral spelling
Term
central agraphias
(dysgraphias)
Definition
three types; phonoloigical, lexical(surface), and deep
Term
phonological agraphia
Definition
-ability to write familiar words, both regular and irregular, but is unable to spell nonwords

-good performance in legitimate words is observed even in low-frequency words, that contains unusual spelling patterns
Term
phonological agraphia
Definition
-striking inability to write legitimate pseudowords under dictation

-spelling errors observed in this group of patients are not usually phonoligically correct but may present a high degree of visual similitude with the target word.
Term
lexical (surface) agraphia
Definition
-dysfunction on the lexical system

- the disorder is characterized by difficulties for spelling irregular and ambiguous words with a preserved ability to spell regular words
Term
lexical (surface) agraphia
Definition
-dysorthography in Spanish

-the patient ability to write decrease as the orthographic ambiguity of the target word increases. as in surface alexia, the word frequency plays a decisive role
Term
deep agraphia
Definition
- refers to a writing disorder characterized by:
1- the inability to spell nonwords and function words
2-better spelling of the highly imaginability than low imaginability nouns
3-semantic paragraphias
Term
deep agraphia
Definition
also associated with phonological agraphia, and consequently these patients present lesions at the level of the supramarginal gyrus and the insula, but their lesions are notoriously more extended
Term
peripheral agraphias (dysgraphias)
Definition
affect only one spelling modality. usually a good oralspelling associated with difficulties in writing have been reported (occasionally, the opposite pattern has been found)
Term
spatial (afferent) agraphia
Definition
associated with right hemisphere lesions has been relatively well analyzed
-Lebrun (1976) proposed to name this type of agraphia as "aferent agraphia"
Term
apraxic agraphia
Definition
the main defect is situated at the level of implementing the peripheral motor processes, the "graphic motor patterns"
-writing is correct from the point of view of spelling, even though letters may be seriously deformed
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