Slowly progressive apraxia: A case report.

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  • 緩徐進行性失行症の一例

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Abstract

    A 69-year-old right-handed man with a 4-year history of slowly progressive clumsiness of the right hand is described. There were no neurological findings of parkinsonism, motor weakness, abnormal involuntary movement, or sensory disturbance, except for hyperreflexia of the right extremities and the right Babinski sign. He was neither demented (WAIS-R IQ115) nor aphasic. There was no visuospatial impairment. His clumsiness was limited to the distal portion of his right arm, whereas his conventional gestures with the proximal portion of his arm were relatively good. His clumsiness was seen equally in manipulating objects and in pantomiming, and no dissociation was noted between automatic and intentional movements. These features are compatible with limbkinetic apraxia. MR imaging revealed mild atrophy of the left precentral area and bilateral frontal lobes without ischemic change. 99mTc-ECD SPECT showed decreased blood flow in the left temporal lobe, the left precentral area, and bilateral superior and middle frontal gyri. The right-sided limbkinetic apraxia was attributed to the dysfunction of the left precentral area, and a clinical diagnosis of slowly progressive apraxia was concluded. Compared with hitherto reported cases, the present case is the purest one presenting a clinical picture of slowly progressive apraxia. Although a few autopsy cases in the literature have been diagnosed as Pick's disease, another possible diagnosis of the present patient could be corticobasal degeneration.

Journal

  • Higher Brain Function Research

    Higher Brain Function Research 17 (3), 258-265, 1997

    Japanese Society of Aphasiology (Renamed as Japan Society for Higher Brain Dysfunction)

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