Compendium of regional diagnosis in affectations of the brain and spinal cord / Translated by F.S. Arnold.

  • Bing, Robert.
Date:
1913
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Licence: In copyright

Credit: Compendium of regional diagnosis in affectations of the brain and spinal cord / Translated by F.S. Arnold. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    sewing, etc.) cannot be executed at all. The underlying condition here is a lesion of the motor area governing the affected limb, a lesion which, while not leading to paralysis of the limb, effaces the kinsesthetic memory-pictures on which its ordered movements depend. 3. Ideo-motor apraxia. In this form ideation and the motor centres for movements of the limb with their kinses- thetic memory-pictures are both intact. Their connection, however, with each other is interrupted. Simple move- ments whose execution is, so to speak, laid down in memory- pictures in the motor centre, are, therefore, executed cor- rectly, but when forming part of a larger movement-sequence they are brought in mal apropos, in incorrect relation with other elements of the sequence. The orders of the ideation centres no longer reach in correct form the motor centre for the limb, which has become to a certain extent independent of general cerebral control. Ideo-motor apraxia is found under two separate sets of conditions : Firstly, in general, when the senso-motor cortex, while retaining its integrity, is cut off from other cortical areas, especially from the centres for the storing up of verbal and material concepts, in the temporal and occipital lobes. Thus, lesions in the parietal lobe occasionally cause apraxia of the opposite hand. The apraxic agraphia, which may be present as one of the symptoms of such a lesion, is to be distinguished, pathogenetically, from aphasic agraphia. In the second place, apraxia of the left hand may be observed when its senso-motor area in the right cortex, while remaining itself intact, has lost its connection with the senso-motor area of the left hemisphere. The left hemisphere reveals, at any rate in right-handed individuals, its functional superiority, in this respect also, that its senso- motor area exercises a controlling influence over the activity of that of its fellow. This control is exercised solely by means of the commissural fibres of the corpus callosum. Apraxia of the left hand is found, therefore, in lesions which sever the callosal fibres or their prolongations, whether the inter- ruption be in the corpus callosum itself * or in one of the two * If the apraxia is associated with a bilateral hemiparesis without hyper-reflex or Babinski's sign, it is probable that the interruption is