A patient shows a specific pattern of language-comprehension disturbance. Before revealing the answer, decide what distinguishes agnostic alexia from pure word deafness.

Ask whether the disturbance affects written language or spoken language comprehension. Agnostic alexia differs from pure word deafness in affecting written rather than spoken language comprehension: the person can see letters and words clearly but cannot understand them as language, while spoken language comprehension and production are generally preserved. Pure word deafness is the reverse pattern: spoken words are not understood despite being heard, while reading and writing are typically preserved, since the deficit there is specific to spoken language. Whether the affected channel is written or spoken language is the key distinguishing feature.