(1) aphasia agraphia is a form of language expression, so agraphia is also a part of aphasia. Aphasia agraphia, like aphasia, can be divided into two basic forms: fluent agraphia and non-fluent agraphia
1. Unfluent agraphia
Most patients with non-fluent aphasia can produce agraphia corresponding to non-fluent aphasia. Most patients with non-fluent aphasia have left-handed writing, which is characterized by less writing, laborious writing, clumsy fonts, short writing, lack of grammaticalized words, more obvious in spoken language than grammaticalization, difficult spelling and almost inevitable omission of strokes.
2. Fluency agraphia.
Most patients with fluent aphasia do not have hemiplegia, but they write a lot or a lot without effort, the font is neat, the sentence length is normal, the spelling is difficult, there are a lot of phonetic and semantic spelling errors, and most of them are similar to random or typos.
3. Other aphasia agraphia
Patients with complete aphasia show serious agraphia, which is limited to writing a few words, and has the characteristics of unsmooth agraphia, but they write less, are not graphical, and cannot be copied through the cortex. The writing of mixed aphasia is similar, but it may be that many patients with named aphasia are accompanied by different degrees of agraphia, and named aphasia without agraphia is rare.
4. alexia and alexia
The dyslexia patients' reading and writing ability is impaired, that is, acquired illiteracy. Without exception, these patients have problems such as naming difficulties, abnormal writing, fluency and agraphia. The lesion is located in the parietal lobe of the dominant language hemisphere.
5. Gerstmann syndrome
The patient's agraphia is characterized by fluent agraphia, effortless writing, missing letters, or meaningless words formed in the wrong order of letters. If agraphia has four components that constitute Gerstman's syndrome, but it does not have fluency characteristics, it is not a real Gerstman's syndrome.
6. Pure agraphia
It means that the function of other languages is normal or close to normal except writing difficulty. Whether the so-called Exner District exists has been debated for a long time. So far, there is no more evidence to support the existence of Exner Writing Center. It has been reported that lesions in the left parietal lobe can cause pure agraphia, and it has also been reported that focal lesions in other parts can cause pure agraphia.
7. Chaos agraphia.
Refers to speech dysfunction caused by various reasons, such as drug poisoning, metabolic encephalopathy or anesthesia. Some patients' oral expression, understanding, retelling, naming and reading skills are normal or close to normal, but their writing function is impaired, which is characterized by scribbling and unclear expression.
8. Deep agraphia.
Patients with deep agraphia appear semantic substitution in writing, that is, semantic misspelling, and the lesions are mostly located in the parietal lobe of the dominant hemisphere.
9. Broken line agraphia.
Dissociative agraphia often occurs after corpus callosum resection. The patient's right hand writing is normal or close to normal, but spontaneous writing completely fails, and no meaningful writing materials can be written.
(2) The writing function of non-aphasic agraphia is closely related to speech function, as well as motor and visual space function. Therefore, motor or visual space dysfunction will interfere with normal writing and even cause serious writing disorders, including motor agraphia, visual space agraphia and hysterical agraphia.
(3) Hypergraphia can occur in the following two situations: (1) Patients with complex partial epilepsy with personality changes write a lot, with strong emotional color, often containing philosophical, political or religious content, but more are general and empty excessive writing content, which is more common in temporal lobe lesions. (2) Schizophrenia patients write too much, and the content is weird, which reflects the serious thinking disorder of patients.