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From the Department of Neurology, Showa University School of Medicine (Drs. Fukui, Sugita, and Kawamura); the Cerebrovascular Disease Center, Ushioda General Hospital (Dr. Shiota); and the Department of Neuropathology, Tokyo Metropolitan Institute for Neuroscience (Dr. Nakano), Tokyo, Japan.
Received October 2, 1995. Accepted in final form December 15, 1995.
Address correspondence and reprint requests to Dr. Toshiya Fukui, Department of Neurology, Showa University School of Medicine, 1-5-8 Hatanodai Shinagawa-ku, Tokyo 142, Japan.
A 62-year-old right-handed man gradually experienced increasing difficulty with speech and manual dexterity. He had apraxia of speech, buccofacial apraxia, and complex limb apraxia as well as terminal dementia. At autopsy, focal cortical atrophy, neuronal loss, and neuropil rarefaction in the second and third cortical layers were most prominent in the left opercular, lower precentral, superior parietal, and left temporal pole. Numerous Pick bodies were diffusely present in the temporal and posterior frontal lobes and, to a lesser degree, in the superior parietal lobule. This report demonstrates an association between the distribution of Pick's pathology and several apraxic impairments.
NEUROLOGY 1996;47: 467-473
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