Nakamagoe K, Hayashi A, Ohkoshi N, Tamaoka A, Shoji S
Department of Neurology, Institute of Clinical Medicine, University of Tsukuba, Japan.
No To Shinkei. 1997 May;49(5):455-9.
We reported a rare case who had hypoxic-encephalopathy causing frontal apraxia of gait. The patient, a 34-year-old female, was admitted in July, 1994, complaining of difficulty in walking after anoxic brain damage caused by ventricular arrhythmia. She had difficulty in raising her feet, which appeared to be rooted to the floor. There was no evidence of motor paralysis, spasticity, rigidity or sensory loss, but she did show frontal lobe signs such as foot grasp reflex and Gegenhalten. Cranial MRI showed slight atrophy of the frontal lobe. On T2 weighted image, high-intensity areas were detected at the posterior internal capsule and corona radiata. Single photon emission CT (123I-IMP) demonstrated a low perfusion area which included the inferomedical part of the frontal lobe. After 8 months of hospitalization, her postural instability and unsteady gait slowly improved without treatment as frontal signs such as foot grasp reflex disappeared. We speculate that her apraxia of gait may result from grasp reflex and Gegenhalten.
我们报告了一例罕见病例，该患者患有缺氧性脑病，导致额叶步态失用症。患者为一名34岁女性，于1994年7月入院，主诉因室性心律失常导致缺氧性脑损伤后行走困难。她抬脚困难，似乎双脚扎根于地面。没有运动麻痹、痉挛、强直或感觉丧失的证据，但她确实表现出额叶体征，如足抓握反射和 Gegenhalten 征。头颅磁共振成像显示额叶轻度萎缩。在T2加权图像上，在内囊后肢和放射冠检测到高信号区。单光子发射计算机断层扫描（123I-IMP）显示一个低灌注区，包括额叶的内下部分。住院8个月后，随着足抓握反射等额叶体征消失，未经治疗，她的姿势不稳和步态不稳逐渐改善。我们推测她的步态失用症可能由抓握反射和 Gegenhalten 征引起。
