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NEUROLOGY 1990;40:657
© 1990 American Academy of Neurology

Diagonistic dyspraxia

Case report and movement-related potentials

Yasufumi Tanaka, MD, Hideaki Iwasa, MD and Mitsuo Yoshida, MD

Departments of Neurology (Drs. Tanaka and Yoshida) and Neurosurgery (Dr. Iwasa), Jichi Medical School, Tochigi, Japan.

We report unusual motor behavior of the left hand dissociated from conscious volition in a 51-year-old right-handed man. This patient had sustained damage to the anterior two-thirds of the corpus callosum, the rostral and lower parts of the right medial frontal lobe, and a small portion of the left medial frontal lobe. He subsequently showed 4 types of abnormal motor behavior in the left hand that were triggered by voluntary activities of the right hand: symmetric or antagonistic left hand movements; irrelevant movements of the left hand to the right hand; and a tendency to close the fingers of the left hand into a fist. Recordings of movement-related potentials revealed a marked attenuation of the Bereitschaftspotential (BP) over the right hemisphere observed only when the patient initiated voluntary activity with the right hand. Since the BP is believed to represent a cerebral cortical activity preparatory for voluntary movement, we infer that the level of dysfunction in this patient is at the motor preparatory level caused by a disconnection of the right hemisphere from the left.

Address correspondence and reprint requests to Dr. Yasufumi Tanaka, Department of Neurology, Jichi Medical School, 3311-1 Yakushiji, Minamikawachi, Tochigi, 329-04, Japan

Received May 24, 1989. Accepted for publication in final form September 15, 1989.




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