title: [Motor initiation difficulty of right upper extremity induced by tactile-stimulation after infarction in the left anterior cerebral artery territory].
abstract: We report a patient who manifested motor initiation difficulty of the right upper extremity, which was caused by tactile-stimulation on his right palm or back. The patient was a 62-year-old right-handed man, who showed reduction of spontaneous speech, slight paresis in the right lower extremity, and left unilateral ideomotor apraxia. He initially showed grasping reflex in the right hand, which disappeared in a month. MRI revealed infarction in the left medial frontal lobe and anterior-half of the corpus callosum. He complained that he was not able to initiate to move his right hand after his right palm or back touched something. He showed no paresis, no abnormal muscle tonus, no involuntary movement. Detailed examination revealed that it was an initiation disturbance caused by tactile-stimulation on his right palm or back. We concluded that this phenomenon, motor initiation difficulty, is one of the disturbances among motor process such as motor initiation, maintainance, and termination. The medial frontal lobe seems to manage the execution of motor process, therefore, lesions in the frontal lobe cause disturbance of motor process. And tactile-stimulation has a close relation to the reaction through the medial frontal lobe, thus, frontal lobe lesion may cause a misinteraction which retrieves a wrong reaction from a certain stimulation.
authors.affiliation: Department of Neurolgy, Niigata University.
authors.forename: M
authors.initials: M
authors.lastname: Otsuki
authors.forename: Y
authors.initials: Y
authors.lastname: Soma
authors.forename: M
authors.initials: M
authors.lastname: Arai
authors.forename: S
authors.initials: S
authors.lastname: Tsuji
mesh_terms: D001132:Arm / Q000503:physiopathology*; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005625:Frontal Lobe / Q000098:blood supply*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010812:Physical Stimulation; D015899:Tomography, Emission-Computed, Single-Photon; D014110:Touch