Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0003635 (apraxia)
 2,817 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case with "releasing phenomenon of well learned praxis" with right hand caused by cerebral infarction in the territory of left anterior cerebral artery. A 71-year-old right-handed woman suddenly developed motor paralysis in right lower and upper limbs associated with mutism. Motor paralysis of the right upper limb and speech disturbance improved gradually. At this period it was noted that she grasped and used an object in front of her with right hand against her own will. The neurological findings about one month after the onset of the disease revealed very mild weakness of the right upper extremity and severe motor paralysis of the right lower limb. In addition, tendon reflex was exaggerated in the right lower limb and sensory disturbance was noted in the region distal from the right knee. Neuropsychologically, ideomotor apraxia was observed in the left hand. Pathological gasping of the right hand was also noted. When the patient saw and touched an object, she used it with her right hand against her own will, and her left hand voluntarily hindered the right hand. This behavior is apparently similar with the "compulsive manipulation of tools" reported previously. However, the following hitherto unknown phenomena were observed in the present patient: Her right hand performed pantomimic movement for the use of objects orally described by the examiner without visually presenting them. The right hand also tended to imitate the gestures of the examiner automatically, even if the patient was not asked for imitating the gestures. These behavioral abnormalities of the right hand was thought to be liberated from the inhibition system.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Releasing phenomenon of well learned praxis with right hand]. 193 60

Ptosis occurs in a variety of disorders including myasthenia gravis, oculomotor palsy, Horner's syndrome and brain stem disorders. There are also supranuclear lesions causing blepharoptosis. The latter disorders are reflex blepharospasm, apraxia of eyelid opening and Meige's syndrome. Since the total number of bilateral ptosis associated with cerebral hemispheric lesions is very few, whether the responsible lesions are located in the nondominant hemisphere or bilateral hemispheres are still controversial. We report here a case of bilateral cerebral ptosis that occurred in association with cerebral infarction of the nondominant hemisphere.
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PMID:A case of bilateral ptosis associated with cerebral hemispheric lesions. 207 18

A study of clinical features and an analysis of gait with floor reaction forces and EMG of leg flexors and extensors were made in patients with multiple cerebral infarction or patients with Parkinson's disease having frozen gait. A case with occlusion of the bilateral anterior cerebral arteries resulting in massive infarction of the infero-medial part of the frontal lobes was also studied as he showed a unique disorder characterized by apraxia of gait. Frozen gait is characterized by shuffling steps, broad-based stance, positive foot grasp, kinesia paradoxa and disturbance of postural reflexes. The vector angle which shows foot pressure in forward locomotion was decreased in patients with frozen gait. EMGs of lower leg muscles in frozen gait were grouping of potentials corresponding to the shuffle and reciprocity between flexors and extensors was preserved. The patient with infarction of the bilateral anterior cerebral arteries showed a peculiar disorder of gait which was characterized by an inability to initiate stepping. It is considered as "apraxia of gait" in a classical sense, which differs from frozen gait. Observation of this patient suggests that the infero-medical part of the frontal lobe plays an important role in the initiation of gait. Furthermore, common features of frozen gait in patients with Parkinson's disease and in patients with multiple cerebral infarction involving the frontal lobe suggest that the nigrostriatal structures and the frontal lobe are important in CNS mechanisms subserving smooth locomotion.
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PMID:[Clinical and physiological study of apraxia of gait and frozen gait]. 275 55

A 74-year-old right-handed man with multiple cerebral infarction who presented with dementia simulating dementia of Alzheimer type (DAT) is reported. He had been well until April 20, 1987 when he developed transient right hand palsy lasting overnight. Eleven days later, he became confused, disorientated, and amnestic. He was admitted to this hospital on June 8. Physical examination revealed hypertension (170/90mmHg). On neurological examination, his consciousness was clear but he was demented. He showed disorientation, amnesia, and urinary incontinence. His most prominent symptom was disturbance of speech, including fluent aphasia and alexia with agraphia. Additionally, he showed ideomotor apraxia, construction apraxia, right-left agnosia, finger agnosia, and acalculia. On July 9, he had a transient attack of right hemiplegia with confusion. The brain CT scan performed on admission was unremarkable except for cavum septi pellucidum and a small low density area in the right basal ganglia. However, single photon emission computed tomography (SPECT) by 123I-labeled N-isopropyl-p-iodoamphetamine disclosed hypoperfusion of the cerebral blood flow in the border zones of the temporoparietal and frontal lobes on the left. A follow-up brain CT scan taken one month later demonstrated low density in the new areas corresponding to hypoperfusion shown by SPECT. Although the clinical features of the present case resembled those of DAT, dementia in this case was regarded as the result of multiple cerebral infarction since it occurred acutely with mild motor deficits, and brain CT scans and SPECT showed lesions indicating focal cerebral ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Multi-infarct dementia clinically simulating dementia of Alzheimer type. A comparison with angular gyrus syndrome]. 278 20

A right-handed man suffered a left parieto-occipital cerebral infarction, causing agraphia with Gerstmann's syndrome but without major aphasia, alexia, or apraxia. Oral spelling was superior to written spelling. Experiments were performed involving (1) analysis of errors in writing, (2) tasks of visual imagery, and (3) identifying letters drawn without leaving a visual trace. The results suggest that the agraphia and Gerstmann's syndrome are due to a dissociation of language skills and visuospatial skills caused by a dominant parieto-occipital lesion.
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PMID:Pure agraphia and Gerstmann's syndrome as a visuospatial-language dissociation: an experimental case study. 317 2

A prospective clinical and radiological correlation study was performed to determine the frequency, and the clinical and radiological features of callosal infarction. From 1 January 1993 to the end of December 1993 282 cases of cerebral infarction seen in the Neurology service of the University Hospital of Dijon were studied prospectively. Eight cases with callosal ischaemic lesions were identified by CT and MRI. A callosal disconnection syndrome occurred in only five of eight patients, related to a single, large infarct or several infarctions in the anterior part of the corpus callosum. Clinical features were characterised by left ideomotor apraxia, construction apraxia, and left agraphia in all five cases. Alien hand was noted in only two cases. There were gait disorders in three cases with MRI features of multiple lacunes in a large part of the corpus callosum, and also the subcortical areas of both hemispheres. It is emphasised that callosal infarctions are not rare and that they contribute to the clinical features of strokes. As well as the classic incomplete callosal disconnection syndrome, these callosal ischaemic lesions may induce non-specific gait disorders.
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PMID:Clinical and topographical range of callosal infarction: a clinical and radiological correlation study. 767 48

Computed topographic electroencephalography (EEG) was performed on patients with right hemispheric injury due to cerebral infarction to investigate the relationship of wave form pattern with neurologic and neuropsychologic data and activities of daily living (ADL). Neurologic signs, unilateral spatial neglect, motor impersistence, and constructional apraxia were found to have no relation to the wave form pattern of computed topographic EEG. In patients with abnormalities detected by the "Mini-Mental State" examination (MMSE) or the "Kanahiroi" test, and in patients with abnormalities in word fluency, extensive slowing of EEG frequency was commonly observed ipsilateral to the side of the lesion or bilaterally, and the ADL were frequently poor. In contrast, among the patients with slow waves and retained alpha waves, the MMSE, "Kana-hiroi" test, word fluency, and ADL were less abnormal. Computed topographic EEG may thus be a useful tool to evaluate neuropsychological status in rehabilitation patients with cerebral infarction.
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PMID:Computed topographic electroencephalographic study in left hemiplegic patients with higher cortical dysfunction. 831 76

A 56-year-old right-handed man developed a persistent dressing apraxia after a cerebral infarction. On examination eight months after the onset, he showed an extreme difficulty in dressing, which did not improve even after repeated trials. He also showed poor judgement of line orientation, impaired ability on constructive task, and prominent difficulty in right-left discrimination of objects placed in front of him. Interestingly, his right left orientation about his own body was not impaired. Mild left unilateral neglect and left sided visual extinction on double simultaneous stimuli were also present. No other neuropsychological signs including aphasia, apraxia, agnosia, asomatognosia and anosognosia were present. The detailed experimental investigations showed that his visual imagery and its mental operation were severely impaired. For instance, he was unable to rotate an imagery object in his mind. We concluded that his dressing impairment was inherently related with this difficulty in rotating an imagery object in the mind. A MRI study showed high signal areas in T2 weighted images in the superior parietal lobule, angular gyrus, occipital cortex, and corona radiata of the right cerebral hemisphere. Also a small lesion was detected in the ventral midbrain through the upper pons.
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PMID:[A case with dressing apraxia]. 904 30

A 69-year-old left-handed man developed Broca aphasia and jargon agraphia following a right cerebral infarction. He learned to write with his right hand. There is no family history of left-handedness. Neurological examination revealed hemiparesis, sensory impairment, and hyperreflexia with pathological reflexes on the left side. An MRI demonstrated lesions in the area including the pre- and post-central gyri, the posterior part of the middle and inferior frontal gyri, and inferior parietal lobule on the right side. Neuropsychologically he was alert and cooperative. He demonstrated severe Broca aphasia and his verbal output was limited to a few residual words. On the other hand, he could communicate through writing Kanji words. Writing words was relatively preserved with Kanji but not with Kana characters. Asked to write a Japanese folk tale, he showed jargon agraphia mixed with some correct Kanji words. His comprehension of spoken and written sentences was well preserved. He showed mild ideomotor and buccofacial apraxia, left unilateral spatial neglect, and constructional impairment. Dissociation between spoken and written language is a prominent feature of this patient's language output. In this patient, right hemisphere seems to be dominant for language and praxis, and left hemisphere for motor engram of writing. Learning to write with the right hand may have enhanced the establishment and maintenance of motor engram for writing in the left hemisphere. The intact motor engram of characters in the left hemisphere could be retrieved by the right hand without control from the language area in the diseased right hemisphere, resulting in jargon agraphia especially with Kana characters. In left handed people, the hand with which they learn to write may effect interhemisphere lateralization of language functions.
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PMID:[Jargon agraphia in a case with Broca aphasia: dissociation between language and writing dominancy]. 929 24

A 64-year-old woman was suffering from rheumatoid arthritis since the age of 57. At the age of 62, she manifested episcleritis of the eyes and rheumatoid nodules in the skin, and rheumatoid factor in the blood became high. These findings indicated the presence of systemic vasculitis, and she was treated with prednisolone. At the age of 64, she suddenly became delirious, and T2-weighted and diffusion-weighted MR images revealed fresh infarctions in bilateral temporal and parietal lobes of the cerebrum. MR angiography failed to show any narrowing or obstruction of large cerebral arteries. She had also high fever and arthralgia, and her blood showed elevated levels of white blood cells, erythrocyte sedimentation rate, C-reactive protein, IgG-rheumatoid factor and immune complex. Lumbar puncture revealed an elevated protein level in CSF. A daily dose of 60 mg prednisolone ameliorated these clinical and laboratory findings as well as her consciousness, disclosing disturbances in higher cortical functions including Wernicke aphasia, disorientation, and ideomotor, ideational, and constructional apraxia. Previous 13 reported cases of cerebral infarction complicating rheumatoid vasculitis were mostly described as showing multiple infarctions in cerebral hemisphere, disturbance of consciousness, elevated protein in CSF, and effectiveness of steroid therapy. The present case had these characteristics, and the cerebral vasculitis mediated by IgG-rheumatoid factor and immune complex was indicated as a probable cause of multiple cerebral infarctions.
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PMID:[Multiple cerebral infarction associated with cerebral vasculitis in rheumatoid arthritis]. 980 88


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