Morel's laminar sclerosis showing apraxia of speech: distribution of cortical lesions in an autopsy case.
A 57-year old man with chronic alcoholism presented with apraxia of speech and disturbance of consciousness. He had a history of gastrectomy and had been drinking alcohol. The symptoms improved with administration of thiamine, but he later developed diarrhea and delirium, and died approximately 40 days after the onset. Autopsy findings were consistent with Wernicke's encephalopathy and pellagra encephalopathy. Furthermore, laminar cortical necrosis with vacuoles and astrocytosis was found in the second and third layers of the bilateral frontal cortices, suggesting Morel's laminar sclerosis. The lesions were mainly located in the bilateral primary motor cortices. Involvement of the lower part of the left primary motor cortex may be associated with apraxia of speech in our case.
Kobayashi
Zen
Z
Department of Neurology and Neurological Science, Graduate School, Tokyo Medical and Dental University, Tokyo 156-8585, Japan. Email: zen@bg7.so-net.ne.jp
Tsuchiya
Kuniaki
K
Takahashi
Mafuyu
M
Yokota
Osamu
O
Taki
Kazuhiro
K
Ishizu
Hideki
H
Arai
Tetsuaki
T
Akiyama
Haruhiko
H
Mizusawa
Hidehiro
H
D000437:Alcoholism / Q000188:drug therapy / Q000473:pathology; D001072:Apraxias / Q000473:pathology*; D001344:Autopsy; D001921:Brain / Q000473:pathology*; D001927:Brain Diseases / Q000473:pathology*; D002908:Chronic Disease; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex; D012598:Sclerosis / Q000473:pathology; D013064:Speech Disorders / Q000473:pathology*; D013831:Thiamine / Q000627:therapeutic use; D014803:Vitamin B Complex / Q000627:therapeutic use
D014803:Vitamin B Complex; D013831:Thiamine