A Case Report of Rehabilitation for Callosal Apraxia of the Right Hand and Disjunctive Motor Disinhibition Syndrome in a Left-handed Patient with Brain Tumor

Tabata Ami, Ueda Keita, Yamao Yukihiro, Tajima Ayumi, Murai Toshiya

doi:10.2496/hbfr.41.227

<p> We report the case of a left-handed patient who developed callosal apraxia in his right hand and disjunctive motor disinhibition syndrome. The patient was a male in his 40s with an intraventricular meningioma. The patient underwent a Wada test before surgery which revealed right hemispheric language dominance. Postoperative changes were found in his corpus callosum and the left-hemisphere medial prefrontal cortex, supplementary motor area, thalamus, and the inferior parietal lobule. Disabilities in activities of daily living occurred owing to a lack of voluntary control over the motor function of his right hand, in addition to coordination disorder in both hands and callosal apraxia in the right hand. Occupational therapy was planned focusing on exercises using the right hand, as well as coordinated exercises with both hands. In addition, to address abnormal movements, exercises guiding the right hand using the left hand, and use of a control method which involves placing the right hand outside the subjectʼs visual field, were applied. Furthermore, verbalization and relaxation techniques were also utilized. In the course of occupational therapy, the callosal apraxia and its associated symptoms ameliorated substantially and the patientʼs daily life improved. Utilizing the functions of healthy limbs as compensation measures is suggested to be important in planning rehabilitation strategies for callosal apraxia.</p>

A Case Report of Rehabilitation for Callosal Apraxia of the Right Hand and Disjunctive Motor Disinhibition Syndrome in a Left-handed Patient with Brain Tumor

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