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[左手失写症——其特征与发展机制]

[Agraphia of the left hand--its characteristics and mechanism of development].

作者信息

Ohigashi Y, Hamanaka T, Asano K, Morimune S

出版信息

No To Shinkei. 1983 Nov;35(11):1065-72.

PMID:6661333
Abstract

We observed 62 y.o. right-handed woman, whose truncus of corps callosum was damaged by infarction of left anterior cerebral artery, that was verified by coronal CT scan finding. She was apraxic and agraphic only with left hand. We examined the characteristics of her unilateral left agraphia from the point of quantitative and qualitative views. These analysis seemed to reveal three main characteristics of unilateral left agraphia of this patient. These were as follows; 1) productive, 2) neographic and 3) iterative. Another important feature of this patient was the mute state during her left-hand writing. Her left agraphia could not explained by apraxic factor, because her copying capacity was remarkably preserved in comparison with her dictation or written naming ability. Furthermore, this agraphia was not aphasic because her right-hand writing was almost intact. We agreed with Yamadori who insisted that this type of agraphia was neither apraxic nor aphasic, but the particular third agraphia which was named as "disconnection agraphia". We considered that the mute state during her left-hand writing might some kind of transient aphasia, which may reflect the functional disturbance of left hemisphere, and the reduced energy in the left hemisphere could increase the activity of right hemisphere. Partial interhemispheric disconnection might induce transient "linguistic anosognosia" in this patient. We believe that these transient hyperactivity and transient linguistic anosognosia could generate above mentioned characteristics of her left agraphia; productive, neographic and iterative.

摘要

我们观察了一位62岁的右利手女性,其胼胝体干因左大脑前动脉梗死而受损,这一点通过冠状CT扫描结果得到证实。她仅左手存在失用症和失写症。我们从定量和定性的角度研究了她单侧左失写症的特征。这些分析似乎揭示了该患者单侧左失写症的三个主要特征。具体如下:1)产出性的,2)新字性的,3)重复性的。该患者的另一个重要特征是左手书写时呈缄默状态。她的左失写症无法用失用因素来解释,因为与听写或书写命名能力相比,她的抄写能力明显保留。此外,这种失写症并非失语症,因为她右手书写几乎正常。我们赞同Yamadori的观点,即这种类型的失写症既非失用性也非失语性,而是一种特殊的第三种失写症,被命名为“分离性失写症”。我们认为她左手书写时的缄默状态可能是某种短暂性失语症,这可能反映了左半球的功能障碍,而左半球能量的减少可能会增加右半球的活动。部分半球间分离可能在该患者中诱发短暂的“语言失认症”。我们认为这些短暂的过度活跃和短暂的语言失认症可能导致了她左失写症上述的特征,即产出性、新字性和重复性。

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