title: Right lower limb apraxia in a patient with left supplementary motor area infarction: intactness of the corticospinal tract confirmed by transcranial magnetic stimulation.
abstract: We reported a 50-year-old female patient with left supplementary motor area infarction who presented right lower limb apraxia and investigated the possible causes using transcranial magnetic stimulation. The patient was able to walk and climb stairs spontaneously without any assistance at 3 weeks after onset. However, she was unable to intentionally move her right lower limb although she understood what she supposed to do. The motor evoked potential evoked by transcranial magnetic stimulation from the right lower limb was within the normal range, indicating that the corticospinal tract innervating the right lower limb was uninjured. Thus, we thought that her motor dysfunction was not induced by motor weakness, and confirmed her symptoms as apraxia. In addition, these results also suggest that transcranial magnetic stimulation is helpful for diagnosing apraxia.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Republic of Korea.
authors.forename: Min Cheol
authors.initials: MC
authors.lastname: Chang
authors.affiliation: Department of Physical Medicine and Rehabilitation, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Republic of Korea.
authors.forename: Min Ho
authors.initials: MH
authors.lastname: Chun
keywords: cerebral infarct; corticospinal tract; lower limb apraxia; nerve regeneration; neural regeneration; stroke; supplementary motor area; transcranial magnetic stimulation