Abstract
Recently, various symptoms such as pathological grasp phenomenon and compulsive manipulation of tools have been reported as symptoms associated with lobus frontalis cerebri facies medialis ˜ antero-callosum injury. We happened to experience the case of an 80-years-old woman who exhibited compulsive manipulation of tools by her right hand in addition to aimless, unconscious movements of both hands and right leg, associated with cerebral hemorrhage of lobus frontalis cerebri facies medialis ˜ antero-callosum bilateralis. Her mouth was synergetic with the movement of her right hand, and on bringing a toothbrush to her mouth, the latter opened. The literature on 29 cases revealed 9 cases of hand synkinesia with the mouth and head and 6 cases of non-synkinesia; no definite inclination was found concerning differences according to cases, thus suggesting the head to have a different mode of control from the hands. Our own patient said that her right hand and leg obey word-induced orders, but do not act voluntarily, as compared with her voluntarily-moving left leg. From this finding, the injury of the present case was regarded as an inter- and intra-hemispheric transection, considering that the center of control of the so-called intentional behaviors lies in the right frontal lobe. In addition to specific limb movements, unconscious and aimless movements of the lips, tongue and neck were observed in the course of her disease. These movements were regarded as manifestations of alienlimb-sign in the above sites.
