[A case of motor neuron disease with dementia and apraxia of the upper limbs].
We report a 61-year-old, right-handed woman with motor neuron disease, dementia, and apraxia of the upper limbs. The patient developed clumsiness of the right hand and dysarthria two years and a half prior to admission. Neurological examination showed limb-kinetic apraxia and ideomotor apraxia, predominantly on the right side, in addition to dementia and anarthria. There was mild muscle wasting in the neck and hands. A muscle biopsy from the biceps muscle of arm as well as needle EMG revealed neurogenic changes compatible with motor neuron disease. Brain MRI indicated pyramidal tract degeneration. Three-dimensional brain perfusion imaging generated from SPECT demonstrated an asymmetric decrease in cerebral blood flow in the fronto-temporo-parietal regions, predominantly on the left side. This case suggests that asymmetric limb apraxia can be associated with motor neuron disease.
Division of Neurology, Department of Internal Medicine, Hyogo College of Medicine.
Bungo
B
Okuda
Yasumichi
Y
Iwamoto
Nobuyuki
N
Oka
Hisao
H
Tachibana
D020240:Apraxia, Ideomotor / Q000209:etiology*; D003704:Dementia / Q000150:complications*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000150:complications*