A right-handed 54-year-old man showed agraphia and acalculia was not able to continue the office work and visited our hospital one year later. He showed slight rigidity and dystonic posture on his right arm. Graphesthesia was found on his right-dominant hands. His main symptoms were significant agraphia, acalculia, ideomotor apraxia, ideational apraxia, and right-dominant limb kinetic apraxia, and logopenic aphasia. His amnesia did not disturb the episodic memory. Brain MRI showed left-dominant bilateral cortical atrophy which was included by the entity of posterior cortical atrophy (PCA). 99mTc-ECD SPECT showed the decreased blood flow on around left angular gyrus and central gyri. DaT Scan showed the mild decreased accumulation on mild left striatum. 11C-PiB PET presented the positive accumulation. His significant agraphia on Japanese characters (kana) and Chinese characters, and apraxia was possible to be caused by the wide functional deficits on around left angular gyrus and it’s dorsal and ventral areas. We suspected the candidate pathology were corticobasal degeneration (CBD) or Alzheimer disease (AD).
