Abstract
Background Alexia without agraphia is a rare deficit in which the flow of visual input from the right hemisphere is prevented from entering the language network of the left hemisphere. The cause for the syndrome is most commonly an infarction in the posterior cerebral artery region. Results A 47-year-old female patient presented with an acute onset of a failure to understand written text and a headache. Clinical examination revealed right homonymous hemianopsia and severe cognitive deficits. MRI with contrast revealed a 4 × 7 cm large periventricular parieto-temporal lesion in the deep white matter of the left hemisphere, which was pathohistologically diagnosed as MS. Conclusions Alexia without agraphia is reported for the first time due to the tumefactive variant of MS. Described complex cognitive deficit was the initial sign of multiple sclerosis.
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