Affiliations: Department of Neurology, Kyung Hee Medical Center,
Kyung Hee University School of Medicine, Seoul, Korea
Note: [] Corresponding author: Key-Chung Park, Department of Neurology,
Kyung Hee Medical Center, Kyung Hee University School of Medicine, 1
Hoegi-dong, Dongdaemoon-ku, Seoul, 130-702, Korea. Tel.: +82 2 958 8447; Fax:
+82 2 958 8490; E-mail: [email protected]
Abstract: Since the Korean language has two distinct writing systems,
phonogram (Hangul) and ideogram (Hanja: Chinese characters), alexia can present
with dissociative disturbances in reading between the two systems. A
74-year-old right-handed man presented with a prominent reading impairment in
Hangul with agraphia of both Hangul and Hanja after a left posterior occipital-
parietal lesion. He could not recognize single syllable words and nonwords in
Hangul, and visual errors were predominant in both Hanja reading and the Korean
Boston Naming Test. In addition, he had difficulties in visuoperceptual tests
including Judgment of Line Orientation, Hierarchical Navon figures, and complex
picture scanning. These findings are consistent with the hypothesis that Hangul
reading impairment results from a general visual perceptual deficit. However,
this assumption cannot explain why performance on visually complex Hanja was
better than performance on visually simple Hanja in our patient. In addition,
the patient did not demonstrate higher accuracy on Hanja characters with fewer
strokes than on words with more strokes. Thus, we speculate that the left
posterior occipital area may be specialized for Hangul letter identification in
this patient. This case demonstrates that Hangul-Hanja reading dissociation
impairment can occur after occipital-parietal lesions.
Keywords: Dyslexia, hangul, hanja, dissociation, posterior occipital area
