Apraxia in a patient with atypical cerebral dominance.
Liepmann postulated that the left hemisphere of right-handed persons contains the "movement formulas" that control purposeful skilled movements of the limbs on both sides of the body. Accordingly, in right-handers apraxia should follow damage to the left hemisphere, whereas right hemisphere damage should not lead to apraxia. Although this is generally true, we recently examined a right-handed man who after a right hemispheric stroke became aphasic and apraxic with his nonparalyzed right hand. Our observations suggest that the right hemisphere of this right-handed man made a critical contribution to the planning and execution of skilled movements. This case provides evidence that right-handers should not be considered a homogeneous group in terms of cerebral motor dominance and that contrary to Liepmann's postulate, hemispheric dominance for the control of skilled movements does not entirely determine handedness.
Rapcsak
S Z
SZ
Veterans Administration Medical Center, Gainesville, FL.
Gonzalez Rothi
L J
LJ
Heilman
K M
KM
D001072:Apraxias / Q000175:diagnosis / Q000523:psychology*; D002544:Cerebral Infarction / Q000523:psychology; D004292:Dominance, Cerebral; D005868:Gestures; D006429:Hemiplegia / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D014057:Tomography, X-Ray Computed