[Left unilateral melokinetic apraxia and left dynamic apraxia following partial callosal infarction].
A 69 year-old right-handed man suffered from an infarct in the left anterior cerebral territory's artery, involving the anterior and middle parts of the corpus callosum, and the cingulum. He had a right crural hemiparesis with a grasp reflex of the right hand, and ipsilaterally a melokinetic and a dynamic apraxia. Agility of the left fingers was lost: fast and nimble movements of theses fingers, and repetitive gestures of the left hand were defective. Execution of motor sequences with the left hand was disrupted by a lack of litheness in gesture series. By analogy with unilateral left ideomotor apraxia, we suggest melokinetic and dynamic apraxia could be symptomatic of an interhemispheric disconnection. Premotor cortex could have a dominance for both digital movements and programmation of gestual sequences. As a general rule, the left cortex could be preferentially activated by the nature of some tasks, particularly the execution of complex gestual series, which implie an internal speech. In theses conditions, an interhemispheric disconnection could lead some difficulties to make theses gestures with the left hand.
Verstichel
P
P
Service de Neurologie, Centre Hospitalier Intercommunal, Créteil, France.
Meyrignac
C
C
D000368:Aged; D001072:Apraxias / Q000175:diagnosis / Q000209:etiology*; D002544:Cerebral Infarction / Q000150:complications* / Q000175:diagnosis; D003337:Corpus Callosum / Q000098:blood supply / Q000473:pathology; D007839:Functional Laterality / Q000502:physiology*; D006179:Gyrus Cinguli / Q000098:blood supply / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012720:Severity of Illness Index