Suzuki Hokuto, Yamamoto Satoshi, Wakatabi Masahiro, Ohtsuka Hiroyuki
aDepartment of Rehabilitation, Zama General Hospital, Zama, Japan.
bDepartment of Physical Therapy, Ibaraki Prefectural University of Health Sciences Hospital, Ibaraki, Japan.
Case Rep Neurol. 2022 Oct 6;14(3):389-396. doi: 10.1159/000525907. eCollection 2022 Sep-Dec.
Mirror movements (MMs) are involuntary synchronous movements of one limb during voluntary movements of the contralateral limb. Generally, MMs after stroke are observed in the unaffected hand during voluntary movements of the affected hand; MMs in the affected hand are comparatively rare. In previous studies, evaluation of MMs in the affected hand was performed using simple unilateral movement tasks, such as tapping or forceful repeated hand closure. However, the impact of MMs of the affected hand on functional tasks, such as activities of daily living (ADLs), has not been reported. We report the rare case of a patient with MMs of the affected hand due to atherothrombotic cerebral infarction of the right postcentral and precentral gyri. An 85-year-old Japanese man presented with left-sided hemiplegia and sensory impairment. MMs were observed in the left (affected) hand during many ADLs and could not be suppressed by the patient's will even when the examiner verbally instructed the patient to move only the unaffected hand. The patient was aware that his hand moved on its own, but he could not control it. The patient was trained on various types of bilateral coordinated motor exercises for 114 days after the MMs were first identified. However, this did not affect MM occurrence, and the MMs remained at the time of discharge. Future research is necessary to plan long-term interventions for MMs of the affected hand.
镜像运动（MMs）是对侧肢体进行自主运动时，一侧肢体出现的非自主同步运动。一般来说，中风后的镜像运动表现为患侧手进行自主运动时，健侧手出现该运动；患侧手出现镜像运动的情况相对少见。在以往的研究中，对患侧手镜像运动的评估采用简单的单侧运动任务，如轻敲或用力反复握拳。然而，患侧手的镜像运动对日常生活活动（ADL）等功能任务的影响尚未见报道。我们报告了一例因右侧中央后回和中央前回动脉粥样硬化性脑梗死导致患侧手出现镜像运动的罕见病例。一名85岁的日本男性，表现为左侧偏瘫和感觉障碍。在许多日常生活活动中，其左侧（患侧）手出现了镜像运动，即使检查者口头指示患者仅移动健侧手，患者也无法通过意志抑制这种运动。患者意识到自己的手会自行移动，但无法控制。在首次发现镜像运动后的114天里，患者接受了各种类型的双侧协调运动训练。然而，这并未影响镜像运动的出现，出院时镜像运动依然存在。有必要开展进一步研究，为患侧手的镜像运动制定长期干预措施。
