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[手势模仿的改变(传导性失用症)]

[Alterations in the imitation of gestures (conduction apraxia)].

作者信息

Politis D G

机构信息

Hospital Interzonal General de Agudos Eva Peron, Buenos Aires, Argentina.

出版信息

Rev Neurol. 2004;38(8):741-5.

Abstract

INTRODUCTION AND AIMS

The aim of this presentation is to report the performance pattern of a patient who suffered ideomotor apraxia with a disorder pattern of the conduction apraxia (CA) type. This clinical picture was originally reported by Ochipa et al. in 1994 as an alteration in the pathway that joins the two lexicons; later, in 2000, Cubelli et al. claimed that there is no evidence for the existence of such a pathway and suggested that the symptoms were due to an alteration affecting the mechanisms governing visuomotor conversion.

CASE REPORT

A 51 year old patient who, following a traumatic head injury, presented aphasia and apraxia with 40% errors in the imitation of familiar gestures test, 50% errors in the imitation of non familiar gestures (NFG), 0% errors in the visual admission of objects test and 0% in the tool usage test. The differences between the performance in the imitation tests and in the other tests are statistically significant. Although the patient displayed slight alterations in the gesture decision test (20% mistakes), alterations to the action input lexicon would not account for the patient's performance since there is a significant difference between his performance in the imitation of NFG test and the gesture decision test. Moreover, he did not present alterations in the discrimination of gestures.

CONCLUSIONS

From the above, it can be said that the patient seems to present CA due to alterations in the non semantic interlexical pathway and in the perilexical pathway, as originally postulated by Ochipa et al.

摘要

引言与目的

本报告旨在呈现一名患有观念运动性失用症且具有传导性失用症(CA)类型障碍模式患者的表现模式。这种临床症状最初由奥奇帕等人于1994年报告为连接两种词汇表的通路改变;后来,在2000年,库贝利等人声称没有证据表明存在这样的通路,并提出症状是由于影响视觉运动转换机制的改变所致。

病例报告

一名51岁患者,在头部外伤后出现失语和失用症,在熟悉手势模仿测试中错误率为40%,在不熟悉手势(NFG)模仿测试中错误率为50%,在物体视觉识别测试中错误率为0%,在工具使用测试中错误率为0%。模仿测试与其他测试表现之间的差异具有统计学意义。尽管患者在手势判断测试中表现出轻微改变(20%错误),但动作输入词汇表的改变并不能解释患者的表现,因为他在NFG模仿测试和手势判断测试中的表现存在显著差异。此外,他在手势辨别方面没有表现出改变。

结论

综上所述,可以说该患者似乎因非语义性词汇间通路和词汇周围通路的改变而呈现CA,正如奥奇帕等人最初所假设的那样。

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