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Extrapontine myelinolysis and pure word deafness are very uncommon disorders. Here, we report a case of a 19-year-old woman who suffered from osmotic demyelination syndrome with coincidence of typical pure word deafness. As a consequence of rapid correction of hyponatremia, the patient demonstrated an initial onset of cortical deafness, and then progressed to generalized auditory agnosia, which eventually developed into confined verbal auditory agnosia (pure word deafness). Bilateral extrapontine myelinolysis was confirmed using brain magnetic resonance imaging. This case suggests that verbal and nonverbal stimuli may involve separate thalamocortical pathways.

Many studies involving lexical access in picture-naming tasks have been undertaken at a point in time, mainly focusing on age of acquisition (AoA). To identify the real determinates of lexical access in recovery and their traces in the brain, we carried out a longitudinal study on a Chinese pure anomic patient using multiple logistic regression analysis. We found that AoA played an important role in early recovery but not in total recovery, whereas familiarity was significant in the whole process. From a new dynamic point of view, our results indicate that AoA and familiarity are the main determinants of lexical access in anomia recovery. We suggest that the changing effects of AoA during recovery may be related to the pathologic process; AoA and familiarity should be taken into account in constructing materials to assess and treat anomic patients.