Verstichel P, Meyrignac C
Service de Neurologie, Centre Hospitalier Intercommunal, Créteil, France.
Rev Neurol (Paris). 2000 Mar;156(3):274-7.
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.
一名69岁的右利手男性，左侧大脑前动脉供血区发生梗死，累及胼胝体的前部和中部以及扣带束。他右侧下肢偏瘫，右手有抓握反射，同侧存在运动不能性失用和动态失用。左手手指灵活性丧失：这些手指的快速灵活运动以及左手的重复手势存在缺陷。左手执行运动序列时，因手势系列缺乏柔韧性而受到干扰。类比单侧左侧观念运动性失用，我们认为运动不能性失用和动态失用可能是半球间联系中断的症状。运动前皮质可能对数字运动和手势序列编程均具有优势。一般来说，某些任务的性质可能会优先激活左侧皮质，特别是执行复杂的手势系列，这涉及内部言语。在这些情况下，半球间联系中断可能导致左手做出这些手势时出现一些困难。
