Timsit S, Logak M, Manaï R, Rancurel G
Urgences Cérébro-Vasculaires, Hôpital de la Salpêtrière, Paris, France.
Brain. 1997 Dec;120 ( Pt 12):2251-7. doi: 10.1093/brain/120.12.2251.
Six patients with cerebral ischaemia who presented evolving isolated hand palsy were studied, five prospectively and one retrospectively. The motor deficit involved only the hand and the wrist in some cases. In almost all cases the motor deficit was pseudo-ulnar. None of them had a Babinski sign, all had mild sensory symptoms or signs in the affected hand. CT and MRI disclosed recent infarctions contralateral to the affected hand, in the white matter of the angular gyrus, in a vascular borderzone. Five had a tight stenosis of the internal carotid artery. The pyramidal tract was anatomically spared in three cases, even considering its parietal origin. Consistent with previous data, our study suggests that the parietal lobe is involved in the control of the motor function of the hand. We propose the existence of a new entity, characterized by an evolving non-pyramidal motor deficit in the hand following infarction of the angular gyrus of the inferior parietal lobe.
对6例出现进行性孤立性手部麻痹的脑缺血患者进行了研究，其中5例为前瞻性研究，1例为回顾性研究。运动功能缺损在某些情况下仅累及手部和腕部。几乎所有病例的运动功能缺损均为假性尺侧。他们均无巴宾斯基征，所有患者患手均有轻度感觉症状或体征。CT和MRI显示，在血管边缘区，与患手对侧的角回白质有近期梗死灶。5例患者颈内动脉有严重狭窄。即使考虑到锥体束的顶叶起源，在3例患者中其在解剖学上未受影响。与先前的数据一致，我们的研究表明顶叶参与手部运动功能的控制。我们提出存在一种新的病症，其特征为下顶叶角回梗死后手出现进行性非锥体运动功能缺损。
