From the Guidelines
The inability to read after a stroke is called alexia, also known as acquired dyslexia or word blindness. This condition occurs when a stroke damages specific areas of the brain responsible for processing written language, typically in the left hemisphere. According to 1, aphasia, which includes difficulties with reading and writing, is a common consequence of stroke, affecting between 21 and 38% of stroke patients. There are several types of alexia, including pure alexia (where patients can write but cannot read, even what they've just written), deep alexia (difficulty with abstract words), and surface alexia (trouble with irregularly spelled words).
Treatment typically involves speech and language therapy with a qualified therapist who specializes in post-stroke rehabilitation, as recommended by 1. Recovery depends on the severity of brain damage, with therapy focusing on compensatory strategies and exercises to rebuild reading skills. Some patients may benefit from assistive technologies like text-to-speech software. Early intervention is crucial for maximizing recovery potential, as the brain has the greatest neuroplasticity in the months following a stroke. Family members can support recovery by practicing reading exercises recommended by therapists and maintaining a patient, encouraging environment. Key aspects of treatment include:
- Speech and language therapy to improve communication and reading skills
- Compensatory strategies to adapt to reading difficulties
- Assistive technologies to support reading and communication
- Early intervention to maximize recovery potential
- Family support and encouragement to facilitate recovery.
From the Research
Definition and Classification
- The condition where a person cannot read after a stroke is called alexia, also known as word blindness, text blindness, or visual aphasia 2.
- Alexia is an acquired type of sensory aphasia where damage to the brain causes the patient to lose the ability to read 2.
- There are different classifications of alexias, including pure alexia with agraphia, pure alexia without agraphia, and alexia associated with aphasia ('aphasic alexia') 2.
Causes and Prevalence
- Alexia can occur after a stroke, and it is estimated that one-third of all stroke patients experience some form of language disorder, including alexia 2.
- The condition can also be caused by other types of brain damage, such as traumatic brain injury 3.
- Reading difficulties after stroke can also be caused by ocular factors, such as visual field loss, eye movement impairment, and poor central vision, as well as non-ocular factors, such as cognitive errors or language impairment 4.
Treatment and Rehabilitation
- Treatment for alexia typically involves targeted therapies aimed at improving whole-word recognition, reading eye movements, and strengthening connections between lexical and semantic representations 5.
- Rehabilitation efforts can be built on a strong theoretical and empirical foundation, and well-designed, single-case studies can inform therapy 5.
- Digital therapeutics, such as Constant Therapy-Research (CT-R), have also been shown to be effective in improving speech, language, and cognitive function in individuals with post-stroke aphasia, including those with alexia 6.