Article

We report on a patient with ideomotor apraxia (IMA) and limb-kinetic apraxia
(LKA) following cerebral infarct, which demonstrated neural tract injuries by
diffusion tensor tractography (DTT). A 67-year-old male was diagnosed as cerebral
infarct in the left frontal cortex (anterior portion of the precentral gyrus and
prefrontal cortex) and centrum semiovale.
The patient presented with severe
paralysis of the right upper extremity and mild weakness of the right lower
extremity at onset. At the time of DTT scanning (5 months after onset), the
patient was able to move all joint muscles of the right upper extremity against
gravity, except for the finger extensors, which he could extend partially against
gravity. The patient showed intact ideational plan for motor performance;
however, his movements were slow, clumsy, and mutilated when executing
grasp-release movements of his affected hand. The patient's score on the
ideomotor apraxia test was 20 (cut-off score < 32). DTTs for premotor cortex
fibers, supplementary motor area fibers, and superior longitudinal fasciculus of
the left hemisphere showed partial injuries, compared with those of the right
side, and these injuries appeared to be responsible for IMA and LKA in this patient.

Langue : ANGLAIS