Agraphia

Abstract For a century after Benedikt (1865) applied the term agraphia to disorders of writing, studies of agraphia focused on the relationship of agraphia to aphasia. Ogle (1867) found that although aphasia and agraphia usually occur together, they were occasionally separable. He concluded that there were distinct cerebral centers for writing and for speaking. Because agraphia and aphasia usually occur together, he concluded that the centers were anatomically close together. Ogle’s classification of agraphia included amnemonic agraphia and atactic agraphia. Patients with amnemonic agraphia wrote well-formed, but incorrect letters. Patients with atactic agraphia made poorly formed letters but usually had an element of amnemonic agraphia as well. Ogle’s two types of agraphia might be termed linguistic and motor. In contrast to Ogle, Lichtheim (1885) proposed that disorders of writing usually were the same as disorders of speech. The exception was agraphia due to disruption of the “center from which the organs of writing are innervated,” which was clinically similar to Ogle’s atactic agraphia. Lichtheim proposed that agraphia and aphasia were similar because the acquisition of writing (and spelling) was superimposed on speech, and therefore utilized previously acquired speech centers. Head (1926) also stressed this relationship. Goldstein (1948) also emphasized two types of agraphia: primary agraphia resulting from disruption of the motor act of writing, and secondary agraphia, resulting from disturbances of speech.