中国神经再生研究(英文版) ›› 2015, Vol. 10 ›› Issue (2): 325-327.doi: 10.4103/1673-5374.152389

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

左运动辅助区梗死患者右下肢失用:经颅磁刺激证实皮质脊髓束完整

  

  • 收稿日期:2014-12-04 出版日期:2015-02-17 发布日期:2015-02-17

Right lower limb apraxia in a patient with left supplementary motor area infarction: intactness of the corticospinal tract confirmed by transcranial magnetic stimulation

Min Cheol Chang, Min Ho Chun   

  1. Department of Physical Medicine and Rehabilitation, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Republic of Korea
  • Received:2014-12-04 Online:2015-02-17 Published:2015-02-17
  • Contact: Min Ho Chun, M.D., Ph.D., mhchun0@gmail.com

摘要:

我们应用经颅磁刺激对1例50岁主要波及运动辅助区的左前大脑动脉梗死女性患者右下肢运动功能障碍的原因进行探究。患者在入院后3周时能独立行走和爬楼梯,但其不能在指令下完成移动右下肢动作。经颅磁刺激诱发的右下肢运动诱发电位在正常范围内,说明支配右下肢运动的皮质脊髓束未受损。由此认为患者的运动障碍是失用症而非肌无力。同时也提示经颅磁刺激有助于诊断失用症。

关键词: 神经再生, 下肢失用, 运动辅助区, 脑梗死, 经颅磁刺激, 皮质脊髓束, 脑卒中

Abstract:

We reported a 50-year-old female patient with left supplementary motor area infarction who presented right lower limb apraxia and investigated the possible causes using transcranial magnetic stimulation. The patient was able to walk and climb stairs spontaneously without any assistance at 3 weeks after onset. However, she was unable to intentionally move her right lower limb although she understood what she supposed to do. The motor evoked potential evoked by transcranial magnetic stimulation from the right lower limb was within the normal range, indicating that the corticospinal tract innervating the right lower limb was uninjured. Thus, we thought that her motor dysfunction was not induced by motor weakness, and confirmed her symptoms as apraxia. In addition, these results also suggest that transcranial magnetic stimulation is helpful for diagnosing apraxia.

Key words: nerve regeneration, lower limb apraxia, supplementary motor area, cerebral infarct, transcranial magnetic stimulation, corticospinal tract, stroke, neural regeneration