Shape-similar errors in Chinese pure alexia

A 64-year-old literate Chinese man presented with sudden onset of difficulty reading. Examination revealed right homonymous hemianopsia and pure alexia. The oral reading test showed that he often read one character as another one with a similar shape but different meaning and pronunciation (figure 1). Brain MRI showed acute infarction involving the left occipital lobe, medial temporal lobe, and splenium of corpus callosum (figure 2). Pure alexia is a clinical disconnection syndrome that was first described in a patient with a similar infarction by Dejerine in 1892.1 Shape-similar errors may be a phenomenon characteristic of Chinese pure alexia.