Selective Hand Posture Apraxia:

A Review of Four reported Cases

Abstract

Although apraxia examinations emphasize separate assessments for its components, such as hand posture and tool manipulation, reports of patients exhibiting selective hand posture apraxia have been limited to only four cases worldwide. This report aims to systematically elucidate selective hand posture apraxia by reviewing the four reported cases. Specifically, we investigated lesion location, neurologic signs, neuropsychological symptoms, and apraxia component symptoms such as hand posture apraxia to elucidate common features. The review suggests that the brain region associated with hand posture is the left anterior intraparietal sulcus and that selective hand posture apraxia may occur in the right hand with a left-sided lesion. Two of the reported cases had sensory disturbances to varying degrees. Additionally, in all cases, although errors in hand posture were exhibited, individuals were able to use the tools properly once their hand postures were corrected, suggesting an intact ability to manipulate the tools. We propose that separate assessments in apraxia components are necessary, including hand posture, manipulation, tool knowledge. These assessments facilitate more reasonable rehabilitation methods and exploration of the neural basis for each domain.