Dissociative Alexia

To the Editor.—  The syndrome of alexia without agraphia has been encountered many times since Kussmaul¹ first recognized that alexia may exist as an isolated symptom without associated visual loss, aphasia, or dementia. The anatomic basis of the syndrome was described by Déjerine² and more recently elaborated by Geschwind.³ To my knowledge, all reported "pure" cases have documented alexia in one language only.I recently observed a case of a 57-year-old right-handed native American male who was rendered alexic in two languages, English and French, by a left occipital lobe infarction. The degree of reading difficulty, however, was quite different in each of the languages affected, being greatest in his native English and much less severe in French of which he had attained a reading, writing, and speaking knowledge while at high school and college.There was no associated agraphia or aphasia. He had a right homonymous