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Motor impersistence

A right-hemisphere syndrome

Department of Clinical Neurological Sciences, St. Joseph's Hospital, Research Institute, London, Ontario, Canada.

We studied motor impersistence with a standardized clinical test of sustained actions, both in patients with acute focal stroke lesions, who were matched for age and size of lesion, and normal controls. Patients with right-sided lesions had significantly more impersistence than did those with left-sided lesions. The most discriminating tests were eye-closure, mouth-opening, tongue-protrusion, and gaze to the left. Right central and frontal lesions seemed to be more responsible for motor impersistence than were posterior or left-sided lesions. Although motor impersistence is sometimes seen with diffise cerebral disease, it is also a sign of right-hemisphere lesions; the phenomenon is probably related to mechanisms of directed attention that are necessary to sustain motor activity.

Address correspondence and reprint requests to Dr. Kertesz, Department of Clinical Neurological Sciences, St. Joseph's Hospital, London, Ontario, N6A 4V2, Canada.

Supported by Ontario Heart Foundation Grant No. 3–33 and Ontario Ministry of Health Grant No. PR721 to Dr. Kertesz.

Accepted for publication September 12, 1984.

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