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Brain Advance Access published online on September 7, 2006
Brain, doi:10.1093/brain/awl235
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© The Author (2006). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received August 2, 2006
Accepted August 2, 2006

Article

Musical alexia with recovery: a personal account

Ian McDonald 1 *

1 Institute of Neurology, University College London, Queen Square, London, UK

* To whom correspondence should be addressed.
Ian McDonald, E-mail: ian.mcdonald{at}rcplondon.ac.uk


  Abstract

I describe the experience of an acute loss of ability to read music and play the piano accurately and expressively following an embolic infarct of the right angular and supramarginal gyri in a setting of chronic migraine. Other parietal deficits included a small visual field defect, visual hallucinations, prosopagnosia, topographical disorientation, disturbance of perception of velocity of moving objects and dyscalculia. Recovery began within a month of the ictus after instituting a regular practice routine. The ability to read and play polyphony recovered before the ability to read homophonic music. A substantial degree of recovery of musical function occurred within 6 months and of the other parietal deficits over a year. Failure to maintain regular practice led to marked though recoverable deterioration. An increased frequency of migraine persisted for some 18 months.

Keywords: cerebral infarction; parietal lobe; angular gyrus; supramarginal gyrus; prosopagnosia; dyscalculia; spatial disorientation; extracampine hallucinations.
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