The Japanese journal of neuropsychology

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ArticleTitle	Neuropsychological examinations for patients with parietal lesions: How should we evaluate them?
Language	J
AuthorList	Chiyoko Nagai
Affiliation	Faculty of Medical Science for Health, Department of Speech-Language Pathology, Teikyo Heisei University
Publication	Japanese Journal of Neuropsychology: 31 (3), 160-168, 2015
Received
Accepted
Abstract	The following paper presents methods for conducting neuropsychological assessments under three types of clinical conditions related to parietal lesions. These methods are based on recent anatomical and functional findings. First, constructional apraxia, now called constructional disabilities, is not usually classified as apraxia; instead, it is assumed to be a deterioration related to visuospatial disabilities. Therefore, the examiner should verify the presence of constructional disabilities, then try to identify their error type (right- or left-hemisphere dominance), the degree of visuospatial impairment, and any comorbid classical limb apraxia (e.g., ideomotor apraxia, ideational apraxia, and limb-kinetic apraxia). Second, in diagnosing Gerstmann syndrome the examiner should not only check for the presence of four symptoms (Gerstmann syndrome's "tetralogy") but also exclude other possible diagnoses as follows: one prominent symptom while three other symptoms are present (e.g., pure agraphia); body-part agnosia not limited to the fingers; conduction or Wernicke aphasia; ideomotor or ideational apraxia; constructional or visuospatial disabilities. Third, when evaluating a patient with suspected corticobasal degeneration, the patient should be carefully examined for the presence of limb-kinetic apraxia and motor-speech disorders, including aphasia, dysarthria, and apraxia of speech. Moreover, executive functions and visuospatial abilities also must be examined to diagnose all subtypes of corticobasal degeneration.
Keywords	constructional disabilities, constructional apraxia, Gerstmann syndrome, corticobasal degeneration, corticobasal syndrome