This study investigated the relation of apraxia to the nature of the stimulus which is given to elicit the gesture. Patients were required to perform a movement imitation test and to demonstrate the use of the same ten objects, once on verbal command, once with the object shown but not handled, and once with the object handled but not seen. One set of comparisons concerned the performance on two tasks involving the visual modality, movement imitation and use of objects presented visually. Although the majority of left brain-damaged patients either failed or passed both tests, there were at least 13 patients who showed an exceedingly poor performance on demonstration of use as compared to imitation. We infer that the distinction between ideational and ideomotor apraxia is warranted. Another set of comparisons concerned the performance on the use of objects presented in the verbal, visual and tactile modalities. A greater percentage of patients failed on the verbal or visual modalities than on the tactile modality. Out of 64 left brain-damaged patients who were diagnosed as apraxic in at least one modality, 23 had an exceedingly poor score on one test as compared to their score on either or both other tests. Fourteen patients selectively failed on verbal presentation, 14 on visual presentation and 2 on tactile presentation. These findings are viewed as supporting the hypothesis that apraxia results from the disconnection between the areas where information is processed and the areas where the movement is programmed.
A case of spinal epidural haematoma diagnosed by means of Gadolinium-DTPA-enhanced MR imaging is described. The sensitivity of this recent technique is underlined.
A retrospective study of all admissions to the University of Modena Neurological Department from 1976-1986; 51 cases of amyotrophic lateral sclerosis (ALS) were found. ALS mean annual incidence was 0.78/100,000 inhabitants, while prevalence was 2.35/100,000. Mean age at onset was 61.43 years, mean and median duration of illness were, respectively, 28.83 and 24.5 months, and survival at 5 years post-onset was 24.4%. A tendency to higher incidence and prevalence of ALS in the ceramic district, when compared with those of the rest of the province was found. However, the small number of cases did not allow any conclusive statistical correlation between environmental exposure to lead and frequency of ALS.
Two hundred and twenty three right-handed patients consecutively admitted to the wards in a 21-month period for a left-sided cerebrovascular disease were examined 15 to 30 days after the stroke for the presence of aphasia. Twenty-seven of them could not be assessed. Of the remaining 196, 108 (55.1%) were aphasic. The incidence of global aphasia (43%) in the latter group was higher than in previous studies. Based on CT-scan data it was associated in 32% of patients with a deep lesion and only in 53% with an antero-posterior cortical-subcortical lesion, contrary to what is traditionally assumed. There was no sex difference in the incidence and distribution of aphasia.
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