Article

We report on a chronic stroke patient who showed motor recovery by
improvement of limb-kinetic apraxia (LKA) after undergoing intensive
rehabilitation for a period of one month, which was demonstrated by diffusion
tensor tractography (DTT) and transcranial magnetic stimulation (TMS). METHODS: A
50-year-old male patient presented with severe paralysis of the left extremities
at the onset of thalamic hemorrhage. At thirty months after onset, the patient
exhibited moderate weakness of his left upper and lower extremities. In addition,
he exhibited a slow, clumsy, and mutilated movement pattern during grasp-release
movements of his left hand. During a one-month period of intensive
rehabilitation, which was started at thrity months after onset, the patient
showed 22% motor recovery of the left extremities. The slow, clumsy, and
mutilated movement pattern of the left hand almost disappeared. RESULTS: DTTs of
the corticospinal tract (CST) in both hemispheres originated from the cerebral
cortex, including the primary motor cortex, and passed along the known CST
pathway. The DTT of the right CST was located anterior to the old hemorrhagic
lesion. TMS study performed at thirty and thirty-one months after onset showed
normal and similar findings for motor evoked potential in terms of latency and
amplitude of the left hand muscle. CONCLUSIONS: We think that the motor weakness
of the left extremities in this patient was mainly ascribed to LKA and that most
of the motor recovery during a one-month period of rehabilitation was attributed to improvement of LKA.

Langue : ANGLAIS