Abstract
We reported a 40-year-old right-handed woman with multiple sclerosis (MS) Who presented right hemiparesis, ideomotor apraxia, crossed optic ataxia of the left hand, and disturbance of speech prosody. MR imaging showed focal lesions in the bilateral posterior limbs of the internal capsule, the left thalamus and curus cerebri, and subcortical white matter in the left anterior lobe, genu and posterior half of the corpus callosum. The ideomotor apraxia and crossed optic ataxia of the left hand were attributed to the lesions of the posterior half of the corpus callosum. Disturbance of speech prosody was thought to have derived from the genu of the corpus callosum.
Neuropsychological symptoms, for example, aphasia, apraxia and agnosia, are rare in MS. In particular interhemispheric disconnection syndrome is very rare in MS (there have been only two case reports). The corpus callosum, however, is a common site of cerebral lesions in MS. In the literature there has been 4 ˜ 20 % callosal distribution of cerebral plaques in MS in pathological studies, and neuroradiological studies (MR imaging) show focal callosal lesions in 30 % of MS cases who have cerebral lesions. The abnormality of the corpus callosum is seen in almost every case in MS (100 % in pathological, 55 ˜ 93 % in neuroradiological studies).
The interhemispheric disconnection syndrome in MS may be overlooked because of its transiency compared with cerebral vascular disease.
