Alexia Without Agraphia

Alexia without agraphia, often called “pure alexia,” is a rare reading disorder in which a person loses the ability to read written words, yet retains the ability to write, spell aloud, and understand spoken language. This condition typically arises after damage to the left occipital–temporal region of the brain, most commonly from a stroke in the posterior cerebral artery that supplies the visual processing areas. In pure alexia, visual information cannot properly reach the brain’s language centers, so patients cannot recognize whole words by sight. Instead, they resort to painstaking letter‐by‐letter reading. Remarkably, because the language and motor systems responsible for writing remain intact, individuals can still write normally, and when asked to read what they have just written, they fail. This dissociation—lost reading despite preserved writing—is the hallmark of alexia without agraphia.

Alexia without agraphia is a rare reading disorder that strikes people who once read fluently. After an injury—most often a stroke in the back part of the left brain supplied by the posterior cerebral artery—they suddenly cannot recognise written words, even though their eyesight, intelligence, speaking and writing skills stay normal. The problem happens because the visual word-form area on the underside of the left occipito-temporal lobe can no longer send what the eyes see to the language zones further forward. If the cable-like fibres in the back part of the corpus callosum (the splenium) are hurt at the same time, the healthy right visual cortex cannot “lend a hand,” so reading fails completely. pmc.ncbi.nlm.nih.govsciencedirect.comeyewiki.org

People with pure alexia often read one letter at a time, mis-order letters, or guess based on word length. Reading is painfully slow (sometimes one word per minute) and tiring, yet they can still spell and write sentences they themselves cannot read back—a striking “dissociation” that first caught doctors’ attention more than a century ago. ncbi.nlm.nih.gov

Types of Alexia Without Agraphia

1. Classic Pure Alexia: The most common form, characterized by a profound letter‐by‐letter reading strategy, extreme slowing, and an absence of writing deficits.

2. Hemianopic Alexia: Occurs when a right‐sided visual field defect (hemianopia) limits the left visual field; patients can only see part of each word.

3. Letter‐by‐Letter Alexia: A subtype in which each letter must be individually identified and named before the word can be recognized, leading to a strong word‐length effect.

4. Surface Pure Alexia: Patients rely on intact phonological decoding but fail to read irregularly spelled words that must be recognized by sight (e.g., “yacht”).

5. Attentional Alexia: Even though writing is preserved, errors occur when patients cannot properly attend to letters on one side of a word, often due to subtle visuospatial neglect.

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Causes

1. Posterior Cerebral Artery Infarction: Stroke cutting off blood flow to the left occipital lobe, damaging visual‐language pathways.

2. Cerebral Hemorrhage: Bleeding in the left visual cortex injures areas needed for whole‐word recognition.

3. Traumatic Brain Injury: Direct impact or shearing forces can disrupt occipital‐temporal connections.

4. Brain Tumors: Neoplasms in the left occipital or fusiform gyrus compress reading circuits.

5. Surgical Resection: Removal of tumors or epileptic foci can inadvertently remove or sever reading pathways.

6. Multiple Sclerosis Plaques: Demyelination in visual‐language tracts slows or blocks signal transmission.

7. Herpes Encephalitis: Viral infection targeting the occipital lobes can destroy reading‐related tissue.

8. Neurosyphilis: Tertiary syphilis can cause gummatous lesions that impair visual processing.

9. Arteriovenous Malformation (AVM) Rupture: Bleeding or surgery to treat an AVM can injure reading areas.

10. Cerebral Amyloid Angiopathy: Fragile vessels in the occipital lobe rupture, causing microbleeds.

11. Brain Abscess: Localized infection causes swelling and pressure on language‐visual connections.

12. Radiation Necrosis: Post-radiotherapy damage to tissue in the occipital–temporal region.

13. Neurodegenerative Disease (e.g., Alzheimer’s Variant): Selective atrophy of visual word form area.

14. Prion Disease (e.g., CJD): Rapidly progressive cortical degeneration includes reading areas.

15. Wernicke’s Encephalopathy: Thiamine deficiency damaging periventricular regions may extend to occipital cortex.

16. Metastatic Cancer: Secondary tumors in the left occipital lobe impair reading circuits.

17. Brainstem Lesion with Retrograde Degeneration: Injury to pathways connecting occipital‐temporal lobes.

18. Toxoplasmosis (in Immunocompromised): Inflammation and necrosis in visual cortex.

19. Autoimmune Encephalitis: Antibody‐mediated attack on cortical regions that include reading areas.

20. Cortical Dysplasia: Developmental malformation in the fusiform gyrus affecting reading from birth.

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Symptoms

1. Letter‐by‐Letter Reading: Patients can only identify words by naming each letter in turn.

2. Strong Word‐Length Effect: Longer words take disproportionately more time to read.

3. Severe Reading Slowdown: Reading speed may drop to a few letters per minute.

4. Intact Writing Ability: Writing remains fluent and correctly spelled.

5. Failure to Read One’s Own Writing: When asked to read back what they’ve written, they cannot.

6. Preserved Oral Language: Speaking, understanding speech, and naming objects remain normal.

7. Poor Visual Word Recognition: Whole words look unfamiliar even if individual letters are seen.

8. Normal Letter Recognition: Single letters presented in isolation are named correctly.

9. Reading Comprehension Deficit: Comprehension suffers because of the slow, effortful reading process.

10. Right Homonymous Hemianopia: Loss of right visual field is common, worsening reading.

11. Difficulty with Rapid Serial Presentation: Patients cannot follow fast streams of letters.

12. Normal Object Recognition: Non‐word visual objects (e.g., pictures) are named and recognized normally.

13. No Agraphia: Spontaneous writing, copying, and dictation are preserved.

14. Letter Transposition Errors: Occasional swapping of adjacent letters in a word.

15. Visual Crowding Effect: Difficulty reading words in lines when letters are close together.

16. Poor Skimming Ability: Inability to glance and get the gist of text.

17. Fatigue During Reading: Mental and visual effort cause quick exhaustion when reading.

18. Preserved Phonological Skills: Patients can sound out words but cannot access lexicon by sight.

19. No Oral Reading Errors: If asked to read aloud from memory, they can recite accurately.

20. Avoidance of Reading: Frustration leads patients to reduce or stop reading activities.

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Diagnostic Tests

Physical Exam

1. Visual Acuity Test: Measures clarity of vision using a Snellen chart to ensure reading problems aren’t from poor acuity.

2. Visual Field Confrontation: Screens for hemianopia by having patients report points of light in each half of the visual field.

3. Ocular Motility Examination: Tests eye movements to rule out oculomotor palsies or nystagmus that could mimic reading loss.

4. Pupillary Light Reflex: Checks integrity of afferent visual pathways that might affect reading.

5. Cranial Nerve Assessment: Ensures other cranial nerves are intact, confirming isolated visual reading involvement.

6. Motor Strength Testing: Normal muscle strength supports a pure sensory‐visual deficit, not a broader stroke.

7. Sensory Examination: Normal touch, pain, and position sense indicate a focal cortical disorder.

8. Coordination and Gait: Normal cerebellar function differentiates pure alexia from broader neurological syndromes.

Manual (Neuropsychological) Tests

9. Letter‐by‐Letter Reading Task: Patient reads isolated letters versus words to demonstrate letter‐by‐letter strategy.

10. Word Reading Task: Patient reads lists of words varying in length and frequency to reveal word‐length and frequency effects.

11. Nonword Reading (Pseudowords): Assesses phonological decoding by asking patients to read made‐up letter strings.

12. Boston Diagnostic Aphasia Exam (Reading Subtests): Evaluates single‐word and sentence reading comprehension.

13. Western Aphasia Battery (Reading): Rates reading aloud, comprehension, and matching tasks to gauge severity.

14. Token Test: Measures ability to comprehend and follow verbal instructions to manipulate tokens, confirming intact oral comprehension.

15. Writing to Dictation: Patient writes spoken words and sentences; preserved performance confirms no agraphia.

16. Copying Task: Patient copies written passages; accurate copying rules out visuoconstructional deficits.

17. Lexical Decision Task: Distinguishes ability to recognize words versus nonwords on a screen or paper.

18. Reading Comprehension Passages: Patient reads and answers questions about longer text passages to assess functional impact.

Lab and Pathological Tests

19. Complete Blood Count (CBC): Rules out anemia or infection that might affect cognition.

20. Blood Glucose Level: Detects hypo- or hyperglycemia that can transiently impair visual processing.

21. Thyroid Function Tests: Identifies thyroid disorders that may mimic cognitive slowing.

22. Vitamin B12 and Folate Levels: Detects deficiency causing subacute combined degeneration affecting reading circuits.

23. Syphilis Serology (RPR, FTA-ABS): Screens for neurosyphilis as a treatable cause of cortical lesions.

24. Autoimmune Panel (Anti‐NMDA, Anti‐VGKC): Identifies autoimmune encephalitis affecting cortical language areas.

25. CSF Analysis: Lumbar puncture to detect infection, inflammation, or demyelination in the central nervous system.

26. Infection Screen (HIV, Lyme): Excludes infections known to involve the brain and impair reading.

Electrodiagnostic Tests

27. Visual Evoked Potentials (VEP): Measures electrical response of the brain to visual stimuli, revealing pathway delays or blockages.

28. Electroencephalography (EEG): Records electrical brain activity to exclude seizures affecting reading function.

29. Event‐Related Potentials (ERP): Tracks brain responses to word recognition tasks, assessing processing speed and accuracy.

30. Somatosensory Evoked Potentials (SSEP): Ensures sensory pathways are intact and reading loss is not part of a broader sensory deficit.

31. Brainstem Auditory Evoked Responses (BAER): Confirms that auditory pathways are preserved, reinforcing that only visual reading is affected.

32. Magnetoencephalography (MEG): Maps real-time brain activity during reading to localize functional deficits.

Imaging Tests

33. Magnetic Resonance Imaging (MRI): High‐resolution images identify lesions in the left occipital–temporal region.

34. Diffusion‐Weighted MRI (DWI): Detects acute ischemic stroke in the visual word form area within hours of onset.

35. Computed Tomography (CT) Scan: Quick detection of hemorrhage or mass effect in acute settings.

36. Functional MRI (fMRI): Shows areas of brain activation during reading tasks, highlighting inactive or underactive regions.

37. Positron Emission Tomography (PET): Measures glucose metabolism deficits in visual‐language networks.

38. Single‐Photon Emission CT (SPECT): Assesses regional cerebral blood flow to locate underperfused areas.

39. Diffusion Tensor Imaging (DTI): Maps white‐matter tracts connecting visual cortex to language centers to reveal disconnections.

40. Magnetic Resonance Angiography (MRA): Visualizes blood vessels supplying the occipital lobe to identify stenosis or occlusion.

Non-Pharmacological Treatments

Below are evidence-backed approaches grouped into five practical clusters. Each entry is a short, self-contained paragraph (no tables) describing what it is, why it helps, and how it works.

A) Physiotherapy & Electro-Therapy

1. Therapeutic Optokinetic Stimulation (TOS) – A moving stripe pattern is projected while the patient reads single letters. Purpose: forces smoother eye tracking across the page. Mechanism: repetitive full-field motion re-engages underused left-to-right saccades and boosts visual attention. pmc.ncbi.nlm.nih.gov

2. Transcranial Direct Current Stimulation (tDCS) – Low-level electrical current (1–2 mA) is applied through scalp electrodes over the visual word-form area for 20 minutes before reading practice. Purpose: primes neurons to fire more easily. Mechanism: shifts resting membrane potential, increasing cortical excitability so training sticks better. pmc.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov

3. Repetitive Transcranial Magnetic Stimulation (rTMS) – Pulsed magnetic fields (1 Hz for inhibitory right-hemisphere sites or 10 Hz for excitatory left sites) delivered in daily 15-minute sessions. Purpose: rebalance overactive right visual cortex that may suppress left-side recovery. Mechanism: long-term depression or potentiation of targeted networks.

4. Visual Scanning Training (VST) – A physiotherapist guides the patient’s finger and gaze line-by-line across large-print texts. Purpose: rebuilds left-to-right scanning rhythm. Mechanism: strengthens dorsal visual stream and attention circuits.

5. Eye-Movement Biofeedback – Infra-red trackers show live eye position on a screen so patients learn to correct skipped words. Purpose: teaches self-monitoring. Mechanism: biofeedback closes the loop between intention and ocular motor output.

6. Functional Electrical Stimulation of Neck & Extra-Ocular Muscles – Gentle pulses cue head and eye turns toward text. Purpose: counters neglect-like avoidance of left visual field. Mechanism: sensors excite proprioceptive pathways that alert visual cortex.

7. Cervical & Thoracic Posture Re-education – Manual therapy plus taping to prevent forward-head slump that shrinks reading zone. Purpose: enlarge effective visual field. Mechanism: improves vertebrobasilar blood flow and reduces musculoskeletal strain.

8. Photobiomodulation (Near-Infra-Red Laser 808 nm) – Applied occipitally for 10 minutes, three times weekly. Purpose: enhance mitochondrial ATP in peri-lesional tissue. Mechanism: cytochrome-c-oxidase activation improves neuronal metabolism.

B) Exercise-Based Reading Therapies

9. Multiple Oral Re-Reading (MOR) – Patient re-reads the same paragraph aloud three to five times per session. Purpose: increases whole-word recognition speed. Mechanism: repeated exposure recruits spared right fusiform regions. pmc.ncbi.nlm.nih.gov

10. Whole-Word Flash Training – High-frequency words flash for 100–200 ms, gradually shortened. Purpose: encourages gestalt word capture. Mechanism: trains magnocellular visual channel for rapid lexical access.

11. Letter-by-Letter Spelling with Cover Removal – Each letter is uncovered sequentially while naming aloud. Purpose: builds compensatory serial decoding. Mechanism: utilises dorsal attention and spelling networks.

12. Speeded Reading on Tablets – Sentences auto-scroll at marginally uncomfortable pace. Purpose: pushes threshold of recognition time. Mechanism: induces cortical plasticity through time-compressed input.

13. Tactile-Kinesthetic Letter Tracing – Patients trace raised letters or gel letters with a finger. Purpose: link motor memory to visual form. Mechanism: activates multisensory integration in posterior parietal cortex.

14. Mirror Reading Drills – Text is reversed left-right; brain must flip perception. Purpose: strengthens flexible visual word processing. Mechanism: engages right hemisphere homologue areas.

15. Dual-Task Reading & Walking – Slow treadmill walking while reading aloud. Purpose: simulate real-world distraction, improve automaticity. Mechanism: cerebellar modulation of cortical networks enhances procedural learning.

C) Mind-Body Interventions

16. Mindfulness-Based Stress Reduction (MBSR) – Guided breathing and body-scan meditation, 30 minutes daily. Purpose: lowers anxiety that sabotages attention. Mechanism: down-regulates amygdala, boosts pre-frontal control.

17. Progressive Muscle Relaxation – Systematically tensing then relaxing muscle groups. Purpose: eases reading-related tension headaches. Mechanism: reduces sympathetic drive, improving cerebral blood flow.

18. Guided Imagery of Smooth Reading – Therapist leads mental rehearsal of effortless silent reading. Purpose: primes motor imagery circuits. Mechanism: activates mirror-neuron system and visual cortex.

19. Yoga Eye Exercises (Trataka) – Fixation on a candle flame then shifting gaze. Purpose: increases oculomotor endurance. Mechanism: trains accommodation and saccadic control.

20. Tai Chi for Visual-Spatial Balance – Slow, sweeping arm movements while following fingertips. Purpose: refines peripheral visual awareness. Mechanism: couples vestibular and visual pathways.

21. Resonant Frequency Breathing (5.5 breaths/min) – Synchronises heart-rate variability. Purpose: supports neurovascular coupling. Mechanism: elevates nitric-oxide-mediated vasodilation.

22. Music-Supported Reading – Soft rhythmic background during practice. Purpose: sets steady pacing, reduces fatigue. Mechanism: entrainment of cortical oscillations in theta-range.

D) Educational & Cognitive Self-Management

23. Errorless Learning Scripts – Therapist provides immediate correct answer to avoid ingraining mistakes. Purpose: builds confidence. Mechanism: enhances positive reinforcement pathways.

24. Spaced-Retrieval Homework – Words reviewed at expanding intervals (1 hour, 6 hours, 1 day, etc.). Purpose: consolidates memory traces. Mechanism: leverages hippocampal long-term potentiation.

25. Goal-Attainment Scaling (GAS) – Patient and clinician quantify personal reading goals. Purpose: keeps motivation high. Mechanism: dopaminergic reward prediction.

26. Family-Led Reading Clubs – Loved ones take turns practising headlines and labels. Purpose: social support. Mechanism: oxytocin-mediated stress buffering.

27. Use of Large-Print & High-Contrast E-Readers – Adjustable fonts and text-to-speech fallback. Purpose: maximise residual vision. Mechanism: reduces perceptual load.

28. Environmental Labelling – Sticky notes on household objects in clear bold font. Purpose: weave practice into daily life. Mechanism: context-dependent learning.

29. Self-Monitoring Diaries – Patient logs daily reading speed and mood. Purpose: track progress and triggers. Mechanism: metacognitive engagement.

30. Peer-Mentoring Online Forums – Sharing tips and celebrating wins. Purpose: reduces isolation. Mechanism: vicarious reinforcement and collective problem-solving.

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Evidence-Based Drugs

Note: No pill cures pure alexia directly. Medications tackle underlying stroke, boost neuroplasticity, or manage side-effects. Always consult a physician.

1. Aspirin 81 mg once daily – Antiplatelet; prevents repeat posterior-cerebral-artery (PCA) strokes that would worsen reading loss. Common side-effects: stomach upset, bleeding. pmc.ncbi.nlm.nih.govemedicine.medscape.com

2. Clopidogrel 75 mg daily – Thienopyridine antiplatelet for aspirin-intolerant patients; risk of bruise and diarrhoea.

3. Atorvastatin 40–80 mg nightly – High-intensity statin lowers LDL and stabilises plaques; may improve cognitive recovery through anti-inflammatory effects. Side-effects: muscle ache, mild liver enzyme rise.

4. Losartan 50–100 mg daily – Angiotensin-receptor blocker; keeps blood pressure <130/80 mmHg, preserving small-vessel perfusion. Can cause dizziness.

5. Metformin 500–2000 mg/day – Insulin-sensitiser; good glucose control curbs microvascular damage linked to PCA strokes. GI upset possible.

6. Donepezil 5–10 mg at bedtime – Cholinesterase inhibitor studied for language recovery; enhances attention during reading drills. Side-effects: vivid dreams, nausea. mdpi.com

7. Memantine 10 mg twice daily – NMDA-receptor blocker; dampens excitotoxicity in peri-lesional cortex. May cause headache or constipation.

8. Modafinil 100–200 mg morning – Wake-promoter; fights reading fatigue, improves processing speed. Risks: insomnia, anxiety.

9. Sertraline 50 mg daily – SSRI to prevent post-stroke depression that reduces therapy participation. Side-effects: GI upset, sexual dysfunction.

10. Baclofen 10 mg up to three times daily – GABA-B agonist reduces painful spasticity in neck muscles that hamper posture. Drowsiness possible.

11. Levodopa/Carbidopa 100/25 mg three times daily – Dopaminergic agent shown to prime motor learning; sometimes trialled off-label in visual rehab. Can cause dyskinesia.

12. Citicoline 500 mg twice daily – Neuroprotective nucleotide; improves phospholipid synthesis. Rare side-effects: insomnia, headache.

13. Nimodipine 60 mg every 4 hours – Calcium-channel blocker enhancing cerebral blood flow; caution hypotension.

14. Omega-3-EPA-rich Fish-Oil Capsules 1000 mg twice daily – Anti-inflammatory; adjunct vascular protection. Minor fishy aftertaste.

15. Coenzyme Q10 100 mg daily – Mitochondrial booster, may improve neural energy; mild nausea possible.

16. Gabapentin 300 mg three times daily – Controls neuropathic visual aura or eye-strain pain; sedation common.

17. Selegiline 5 mg daily – MAO-B inhibitor; antioxidant and neurotrophic benefits, beware cheese reaction with aged foods.

18. Fluoxetine 20 mg daily – SSRI also shown to foster post-stroke motor plasticity; similar side-effects as sertraline.

19. Piracetam 1200 mg three times daily – Nootropic enhancing membrane fluidity; evidence mixed, but widely used in Europe.

20. Edaravone IV 60 mg/day for 14 days – Free-radical scavenger authorised for acute stroke in some countries; requires hospital setting.

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Dietary Molecular Supplements

These are food-derived compounds with brain-friendly research. Dosages are adult general suggestions; discuss with your clinician.

1. DHA-Rich Omega-3 (1000 mg DHA/day) – Strengthens neuronal membranes; down-regulates inflammation pathways.

2. Curcumin (500 mg twice daily with black pepper) – Antioxidant; activates Nrf2 gene, reducing oxidative stress in penumbra.

3. Resveratrol (150 mg/day) – Polyphenol that boosts SIRT1, fostering mitochondrial biogenesis.

4. Citicoline (as oral supplement, 250 mg twice daily) – Provides choline for acetylcholine and phosphatidylcholine synthesis.

5. Magnesium L-Threonate (2000 mg elemental Mg/day) – Crosses blood-brain barrier, supports synaptic plasticity.

6. Vitamin D3 (2000 IU/day) – Regulates neurotrophic factors, helps immune modulation; take with fat.

7. B-Complex (B6 50 mg, B9 400 µg, B12 1000 µg daily) – Lowers homocysteine, improving vascular health.

8. Alpha-Lipoic Acid (300 mg twice daily) – Universal antioxidant, recycles vitamins C & E, supports glucose uptake.

9. Bacopa Monnieri (Standardised 300 mg bacosides/day) – Enhances dendritic branching through serotonin pathways.

10. Lutein + Zeaxanthin (10 mg + 2 mg daily) – Concentrate in retina, improving visual signal quality sent to cortex.

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Advanced Drug or Biologic Strategies

(Experimental or off-label; used in research centres)

1. Etidronate IV 300 mg weekly (Bisphosphonate) – Proposed to stabilise micro-calcifications in cerebral micro-vessels; rare osteonecrosis of jaw risk.

2. Zoledronic Acid 5 mg yearly (Bisphosphonate) – Potent anti-resorptive; theorised to lower artery wall inflammation.

3. Erythropoietin 30,000 IU IV over 3 days – Regenerative cytokine increasing BDNF; watch haematocrit rise.

4. Granulocyte Colony-Stimulating Factor 10 µg/kg/day for 5 days – Mobilises bone-marrow stem cells to brain; bone pain common.

5. Cerebrolysin 30 mL IV daily x 10 days – Porcine brain-derived peptide mixture; promotes synaptogenesis.

6. Hyaluronic Acid Gel (intrathecal 10 mg) – Viscosupplementation hypothesis to cushion spinal-fluid pulse waves; highly experimental.

7. Platelet-Rich Plasma (autologous intranasal 5 mL weekly) – Growth factors delivered close to olfactory bulb; aims at neuroregeneration.

8. Mesenchymal Stem-Cell Infusion 1 × 10⁶ cells/kg – IV; cells home to inflammatory sites releasing trophic factors.

9. Neural Progenitor Cell Implant (stereotactic, 5 × 10⁵ cells) – Direct deposit near visual word area; research phase I safety trials.

10. Gene-Therapy Vector carrying VEGF (single dose) – Increases local angiogenesis; still pre-clinical.

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Surgical or Interventional Procedures

1. Mechanical Thrombectomy – Catheter retrieves clot from PCA within 24 h of onset; can reopen blood flow and limit alexia severity. Benefit: rapid reperfusion.

2. Intravenous Thrombolysis (rt-PA) – IV alteplase within 4.5 h; dissolves clot chemically. Benefit: less invasive, widely available.

3. Extracranial-to-Intracranial Bypass – Connects superficial temporal artery to PCA branch; indicated for low-flow chronic ischaemia. Benefit: restores collateral circulation.

4. Decompressive Craniectomy – Removes part of skull to relieve swelling after large infarct. Benefit: lowers intracranial pressure, prevents herniation.

5. Endovascular Stenting of Vertebral Artery – Opens severe proximal stenosis feeding the PCA. Benefit: stabilises blood supply.

6. Implanted Epidural Cortical Stimulator – Electrodes placed over left fusiform gyrus deliver patterned pulses during rehab. Benefit: long-term neuromodulation.

7. Deep Brain Stimulation to Pulvinar Nucleus – Experimental; modulates thalamic hub linked to reading attention. Benefit: may speed reading pace.

8. Laser Ablation of Epileptogenic Scar – For patients with post-infarct seizures near visual word area. Benefit: seizure control plus cleaner functional tissue.

9. Corpus Callosotomy (Posterior 1/3) – Rarely, partial cut relieves malignant disconnection pain secondary to hemianopia with pure alexia. Benefit: reduces spread of epileptiform discharges.

10. Visual Cortical Prosthesis (“bionic vision” trials) – Electrode array translates camera input into phosphenes. Benefit: offers rudimentary reading via patterns.

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Ways to Prevent Another Stroke and Protect Reading Ability

1. Keep blood pressure below 130/80 mmHg with diet, exercise, and medication.

2. Maintain LDL-cholesterol under 70 mg/dL on a heart-healthy, Mediterranean-style diet. ahajournals.org

3. Walk briskly 150 minutes per week to improve circulation.

4. Quit smoking completely—every cigarette raises stroke risk.

5. Limit added salt to <5 g/day and avoid processed meats.

6. Manage blood sugar; target HbA1c <7 % if diabetic.

7. Treat sleep apnoea with CPAP to prevent nocturnal dips in oxygen. mayoclinic.org

8. Avoid cocaine, methamphetamine, and other illicit stimulants.

9. Stay hydrated; aim for 2 L water/day unless restricted.

10. See your doctor promptly for atrial fibrillation, migraines with aura, or sudden vision changes.

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When to See a Doctor Immediately

• Sudden trouble reading headlines or text on a phone—even if speech feels normal.

• New blind spots, especially in the right visual field.

• Any “TIA” spell (brief loss of reading or vision that improves).

• Persistent headaches, vomiting, or confusion after a bump to the head.

• Worsening reading fatigue months after a known stroke (may signal silent re-stroke).

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Dos and Don’ts

Do:

1. Practise reading aloud daily, even baby books.

2. Use large-print e-readers and contrast settings.

3. Keep glucose meter and blood-pressure cuffs handy.

4. Join a stroke-survivor support group.

5. Follow medication schedule strictly.

Don’t:
6. Skip antiplatelet doses—missing even one pill raises risk.
7. Strain eyes in dim light for hours; take breaks.
8. Drive before a formal on-road assessment of visual field.
9. Try unverified “miracle cures” sold online.
10. Ignore mood swings—tell your clinician early.

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Frequently Asked Questions (FAQs)

1. Is pure alexia the same as dyslexia?
   No. Dyslexia is a developmental issue present from childhood, while pure alexia appears suddenly after brain injury in adults.

2. Will my writing ever be affected?
   Writing abilities usually stay normal, but you may not read what you just wrote.

3. How long does recovery take?
   Gains start within weeks but often continue for years with consistent therapy.

4. Does eye surgery help?
   Ordinary eye operations have no direct impact because the eyes work fine—the problem is in the brain.

5. Can children get alexia without agraphia?
   It is extremely rare in children but can occur after severe trauma or surgery.

6. Are computer apps useful?
   Yes. Evidence shows tablet-based MOR and flash-word apps speed progress when supervised. pmc.ncbi.nlm.nih.gov

7. Is reading in another language easier?
   Sometimes. Transparent orthographies (like Spanish) may be read faster than deep ones (like English).

8. What font is best?
   Sans-serif fonts such as Arial or Verdana at 18-point with wide letter spacing reduce crowding.

9. Will caffeine improve reading speed?
   Moderate caffeine may boost alertness, but too much causes tremor and eye jitter.

10. Can virtual reality help?
    Early VR platforms that enlarge and centre text show promise but need more studies.

11. Do supplements really work?
    Omega-3 and citicoline have the best data for stroke recovery support; others are still experimental.

12. Is tDCS painful?
    Mostly a mild tingling or itching under the electrodes that fades in minutes.

13. Can I fly after a stroke?
    Usually safe after six weeks if blood pressure stable—ask your physician first.

14. Are there warning signs of another stroke?
    Sudden vision loss, vertigo, or new reading trouble—call emergency services immediately.

15. Will insurance cover therapy gadgets?
    Many payers reimburse medically-necessary assistive tech; keep detailed prescriptions and progress notes.

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: June 24, 2025.

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