2009 Volume 29 Issue 4 Pages 408-414
A movement release phenomenon appeared after recurrence of cerebral infarction in the premotor area of the left frontal lobe in a 68-year-old, right-handed male. The movement was a guiding gesture for drivers and pedestrians he had performed in his work as a security guard. The course of the phenomenon was divided into 4 stages based on the appearance of this motion starting from the onset. In Stage 1, the motion actively appeared toward those walking in the hospital corridor and drivers backing their cars as seen out of the hospital window. In Stage 2, the motion appeared when performing tasks such as naming, repeating and pointing. In Stage 3, the motion appeared only during conversations, and in Stage 4 it was gradually resolved. The following conditions may have been involved in the appearance of the guiding gesture in this patient : (1) presence of a severe communication disorder, severe aphasia, in which language communication measures cannot be used ; (2) establishment of the guiding motion as a communication measure in his work ; (3) influence of the impaired frontal lobe function leading to the release phenomenon ; (4) relationship with a speech therapist, i. e., influence of mental aspects arising from interpersonal relationships, such as excitation due to being evaluated, and (5) influence of the patient's character.
