A formal analysis of alexia in persistent aura and a comparison to acquired pure alexia

ABSTRACT

A patient is reported with reversible pure alexia in the context of migraine with aura. Following previous, anecdotal reports, the present study is the first to formally assess word reading, writing, and other linguistic and visual processing and to compare these to a patient with stroke-related pure alexia. The reading impairment, suggestive of letter-by-letter reading, was observed across 7 days but had remitted at a 3-month follow-up. The deficit also affected recognition of letters, suggesting a functional impairment at the level of letter recognition, not just word reading. It went along with reversible abnormalities in diffusion-weighted and fluid-attenuated inversion recovery imaging in areas known to be involved in word reading.

KEYWORDS:

• Alexia
• migraine
• aura
• pure alexia
• headache

Acknowledgments

We are indebted to RE and her husband as well as MR for participating in the study. We would like to thank Professor Wolf Lagrèze for helpful comments on RE’s visual field defect.

Disclosure statement

No potential conflict of interest was reported by the authors.