However, the patient comprehends auditory information and can write and speak normally. This refers to a severe disorder of both reading and writing but auditory comprehension and speech are intact. Acalculia, right-left spatial disorientation and naming deficits are common associated symptoms. Lesions of the left angular gyrus of the parietal lobe result in this syndrome. This disorder is characterized by agraphia without other language disturbance.
Patients make well-formed letters but have characteristic spelling errors.
The important constructs to assess in language are spontaneous speech or fluency, naming, repetition, and comprehension. By delineating a profile of performance in each of these areas the clinician can begin to understand the location of the patient's injury and the nature of the language impairment. This is assessed by requesting the patient to engage in conversation, make social greetings, and describe something, such as a picture. Observations should be made of the patient's speech production. Patients with anterior lesions will have halting, agrammatic, dysprosodic speech which features substantive words, such as the major nouns and verbs.