Mani R B, Levine D N
Neurology Service, Spaulding Rehabilitation Hospital, Boston.
Arch Neurol. 1988 May;45(5):581-4. doi: 10.1001/archneur.1988.00520290121025.
The cerebral hemisphere contralateral to the preferred hand is generally dominant for learned representational motor acts, including those involving buccofacial muscles. It is generally also language-dominant. This buccofacial apraxia has, with rare exceptions, been associated with left hemispheric lesions in right-handers. We describe two patients with severe buccofacial apraxia caused by large middle cerebral artery territory infarcts in the hemisphere ipsilateral to the preferred hand and nondominant for language. Neither patient had aphasia or major limb apraxia. Computed tomographic scans in the first patient and neuropathologic examination in the second failed to reveal an abnormality of the hemisphere contralateral to the preferred hand. Hence, in some individuals, the hemisphere controlling skilled representational buccofacial movements may not be the one that is dominant either for handedness or for language.
对于包括那些涉及颊面部肌肉的动作在内的后天习得的表征性运动行为，通常与优势手对侧的大脑半球占主导地位。它一般也是语言优势半球。除了极少数例外，这种颊面部失用症与右利手者的左侧半球病变有关。我们描述了两名患者，他们因优势手同侧且非语言优势半球的大脑中动脉大片区域梗死而导致严重的颊面部失用症。两名患者均无失语症或严重肢体失用症。第一名患者的计算机断层扫描和第二名患者的神经病理学检查均未发现优势手对侧半球有异常。因此，在某些个体中，控制熟练的表征性颊面部运动的半球可能既不是优势手的主导半球，也不是语言的主导半球。
