Hashimoto Y, Misumi K, Dohsaka H, Kimura K, Uchino M
Department of Neurology, Kumamoto City Hospital.
Rinsho Shinkeigaku. 1996 Jan;36(1):68-70.
A 52-year-old woman was admitted to our hospital because of paralysis of her right lower limb and dysarthria. After admission, she had exacerbations of paralysis of the right lower limb twice. Brain CT scan revealed a low density area in the left anterior cerebral artery territory. MRI disclosed the lesion of the body of the corpus callosum. On the fifth day, trans-esophageal echocardiography detected a mass lesion in the left atrium. There was no recurrence after treatment with heparin. On the 23rd day, the left atrial mass was removed surgically, which was elastic and soft and was confirmed to be myxoma pathologically. It was suggested that the embolic material originated from an adherent thrombus on the surface of the myxoma, since heparin was effective. She showed unique movements of her right hand like diagonistic dyspraxia. The right hand with mild paresis took away an object held in the left hand. The patient was able to move the right hand voluntarily and to imitate with it. She did not show grasping reflex, instinctive grasp reaction and apraxia of the left hand. The lesion of the body of corpus callosum may be responsible for this peculiar neurological symptom.
一名52岁女性因右下肢麻痹和构音障碍入院。入院后，她右下肢麻痹加重了两次。脑部CT扫描显示左大脑前动脉供血区有低密度区。MRI显示胼胝体部有病变。第5天，经食管超声心动图检测到左心房有一肿块病变。肝素治疗后无复发。第23天，手术切除左心房肿块，肿块质地柔软且有弹性，病理证实为黏液瘤。鉴于肝素有效，提示栓子物质源于黏液瘤表面的附着血栓。她右手表现出独特动作，如诊断性失用症。轻度麻痹的右手拿走了左手拿着的物体。患者能够自主移动右手并进行模仿。她未表现出抓握反射、本能抓握反应和左手失用症。胼胝体部病变可能是这种特殊神经症状的原因。
