“Neglect dyslexia” and the early visual processing of letters in words and nonwords

We report the case of a nonphasic patient, VB, who suffered a left-sided neglect which affected her reading (a condition known as “neglect dyslexia”). In text reading she often read only the right halves of lines, and in single-word reading she made errors which affected the initial letters (e.g. RIVER misread as “liver” or YELLOW as “pillow”). Neglect errors to both words and nonwords typically involved the substitution of initial letters rather than deletion or addition, resulting in errors of the same length as the target words. Comprehension of misread words matched the error rather than the target. We propose, following Shallice (1981), that “neglect dyslexia” affects the early visual analysis of letters in both words and nonwords. More particularly we propose that although VB's neglect sometimes prevented the encoding of leftmost letters for identity, processes which assign positions to letters in strings on a left-right spatial basis still responded to the existence of those letters. This fact is held to account for the predominance of substitutions over omissions in VB's misreadings. Finally some possible future dissociations of the symptoms shown by VB are discussed.