Reversing Letters, Asymmetric Tonic Neck, Neck Retraction Reflexes and Apraxia are Predictive of Dyslexia

Background: Dyslexia prevalence, diagnosis, risk factors and even awareness are quite uncertain in Egypt. One of the limitations in dyslexia evaluation for Arabic readers is the absence of rapid easy diagnostic test. The only available Arabic Reading Test for dyslexia is lengthy and only applicable at age 9-10 year where it is late for treatment of dyslexia. Objective: The objective of this study was to find out the frequency, easy neurological predictors of dyslexia and to increase teachers’ awareness of dyslexia. Methods: Two hundred and six students aged 9-10 years old were assessed individually for dyslexia using Arabic reading tests. Detailed history taking and neurological examination with particular emphasis on symptoms suggestive of dyslexia, cerebellar signs, primitive reflexes, and tests for apraxia; were done for all students. Results: Twenty two students (10.67%) were found to be dyslexic. Dysdiadokinesia, asymmetric tonic neck, neck retraction, palmar reflexes and apraxia were significantly higher in dyslexic, P value (0.02, 0.001, 0.02, 0.001, 0.001) respectively. Reversing letters, persistence of the asymmetric tonic neck, neck retraction and apraxia were predictive of dyslexia. Simple instructions for the teachers make their diagnostic efficiency to detect dyslexia (72.1%). Conclusion: Dyslexia is frequent. Asymmetric tonic neck, neck retraction and apraxia tests were predictive of dyslexia. Large national project to tackle dyslexia is recommended. [Egypt J Neurol Psychiat Neurosurg. 2010; 47(3): 453-459]