Laterality and rehabilitation: differences in left and right hand productions in aphasic agraphic hemiplegics

The typical picture of a patient suffering from a left hemisphere cerebral vascular accident (CVA) is that of an aphasic with a right hemiplegia. In such patients the impairment in speech is generally mirrored in written production (Basso et al. 1978). By necessity this agraphia is demonstrated in the left, non-dominant, non-paralysed hand. Due to the concomitant hemiplegia, writing is not normally examined in the dominant right hand. (This situation also holds for praxis.) This raises an important question: in patients with right hemiplegia, could it be demonstrated that the writing disturbance reflects a unilateral left agraphia? In other words, could the dominant, paralysed hand produce written language better than the non-dominant but unparalysed left hand