Case report: An approach to the patient with reading difficulties in the primary care setting

A 79-year old right-handed gentleman was admitted to hospital with a right homonymous quandrantanopia associated with pure alexia (alexia without agraphia). His computed tomography and magnetic resonance imaging revealed an ischemic stroke in the left occipital region. Etiological investigations were unrevealing and the cause of his stroke remains unclear. The alexia was characterized by covert letter-by-letter reading with word length effect accompanied by phonological sound spelling errors and a mild visual anomia. While formal language and reading assessments exist (i.e., by a speech–language pathologist), these are not always widely available or are difficult to administer by a physician in a primary care setting. The purpose of the present paper is to describe an informal bedside approach to the patient presenting with reading difficulties with the goal of identifying patients with alexia for formal language assessment and rehabilitation.