Kim Hee Jin, Kim Dongyeop, Won Da-Heen, Chin Juhee, Lee Kwang Ho, Seo Sang Won, Heilman Kenneth M, Na Duk L
*Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea †Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea ‡Department of Clinical Research Design and Evaluation ¶Department of Health Sciences and Technology, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Republic of Korea §Department of Neurology, University of Florida, Gainesville, Florida ∥Veterans Affairs Medical Center, Gainesville, Florida.
Cogn Behav Neurol. 2017 Jun;30(2):68-72. doi: 10.1097/WNN.0000000000000125.
Motor impersistence, an inability to sustain a certain position or movement, is a motor-intentional disorder, caused more often by right than left hemisphere lesions. Since the right hemisphere is dominant for mediating motor persistence, callosal lesions that disconnect the left hemisphere from the right may induce impersistence of the right upper and lower limbs. After an undiagnosed left callosal infarction, a 65-year-old right-handed man suddenly developed a transient loss of volitional movement of his left leg. Five days after onset, he was admitted to our hospital with signs of callosal disconnection: left-hand agraphia and apraxia, left-hand tactile anomia, failures on cross-replication of hand postures, and intermanual conflict. He had neither weakness nor ataxia of his upper or lower extremities, but when asked to keep his arms or legs extended he could not maintain his right arm and leg in the extended position, suggesting motor impersistence in his dominant limbs. When we examined him 3 months after onset, the motor impersistence had disappeared. In conclusion, motor impersistence of dominant limbs can result from isolated callosal injury that disconnects the left hemisphere from the right hemisphere's frontal-subcortical networks.
运动不能持续，即无法维持特定姿势或动作，是一种运动意向障碍，右侧半球病变比左侧半球病变更常导致该症状。由于右侧半球在介导运动持续性方面占主导地位，胼胝体病变若使左侧半球与右侧半球分离，可能会导致右上肢和下肢出现运动不能持续。一名65岁右利手男性在发生未被诊断出的左侧胼胝体梗死之后，突然出现左腿意志性运动短暂丧失。发病五天后，他因胼胝体分离的体征入院：左手失写症和失用症、左手触觉性命名不能、手部姿势交叉复制失败以及双手冲突。他的上肢和下肢既无无力症状也无共济失调，但当要求他伸展手臂或腿部时，他无法将右臂和右腿保持在伸展位置，这表明其优势肢体存在运动不能持续。在发病三个月后我们对他进行检查时，运动不能持续已经消失。总之，优势肢体的运动不能持续可能源于孤立的胼胝体损伤，这种损伤使左侧半球与右侧半球的额叶 - 皮质下网络分离。
