The Japanese journal of neuropsychology

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ArticleTitle	A case of dressing apraxia after cerebral infarctions -Analysis of errors and mechanism of dressing apraxia-
Language	J
AuthorList	Satomi Inoue¹⁾, Mariko Seki¹⁾, Naoko Shindo¹⁾, Hiroshi Kurisaki²⁾, Mitsuaki Bandoh³⁾
Affiliation	1) Department of Rehabilitation, National Tokyo Hospital 2) Department of Neurology, National Tokyo Hospital 3) Department of Neurology, Tokyo Metropolitan Neurological Hospital
Publication	Japanese Journal of Neuropsychology: 17 (2), 156-163, 2001
Received	Apr 1, 2000
Accepted	Nov 24, 2000
Abstract	A 67-year-old left-handed man experienced dressing disability after several attacks of cerebral infarction. Neurological examination revealed slight left hemiparesis which was thought to be caused by an infarction in the pons. In addition, MRI revealed abnormal signal lesions in the left parieto-occipital junction that extended deep to the posterior horn of the lateral ventricle. A proton high signal lesion existed on the right precentral gyrus. MRA showed left carotid occlusion at the origin and right carotid artery stenosis in the ganglionic portion. Neuropsychological examinations revealed slight left hemi-spatial neglect, constructional disturbance, and slight aphasia with a moderate writing disturbance, none of which could explain his inability to put clothes on. When he needed to dress, he hesitated, rotated the clothes, failed to find the correct sleeve until finally he might introduce the hand into the wrong sleeve. As a result, he put the clothes on the wrong way round or back to front. When putting on a T-shirt, he might introduce his hand into the lower end of the sleeve. He could recognize any part of both his body and his clothes. However, our observations revealed that, when clothes were laid untidily in front of him, he could not spread them out correctly, and he confused the right side of clothes with the left when he was facing their front side. Then we showed him a T-shirt hanging on a wire frame resembling a tailor's dummy, asked him to show by means of gestures how to put it on, and he failed. We concluded that his dressing apraxia might be related to an inability 1) to recognize the spatial relationship of parts of clothes, 2) to rotate them mentally in relation to his body, and 3) to imagine and to perform the actions of dressing. Also, we discussed on problems about responsible lesions of dressing apraxia and an involvement of his anomalous laterality with dressing apraxia.
Keywords	dressing apraxia, left-handed, motor image