Two patients presented with progressive left unlateral motor apraxia a
nd progressive visuo-spatial difficulties, including constructional ap
raxia, dressing apraxia, spatial dysgraphia and dyslexia, spatial acal
culia and neglect of the left side, without significant changes in the
other cognitive functions. In both patients, radiological tests demon
strated cortical atrophy; more marked in the retrorolandic areas. A di
agnosis of Alzheimer's disease was made in the first patient by cortic
al biopsy and in the second patient by post-mortem examination. The se
cond patient died from an intercurrent neoplastic condition early in t
he course. Post-mortem examination of her brain showed the atrophy to
be predominantly in the superior parietal gvri. In these areas, in add
ition to neuritic plagues and neurofibrillary tangles, these was also
severe gliosis and superficial spongiosis. These two cases were clinic
ally different from cortico-basal degeneration, where the motor diffic
ulties are associated with occulo-motor problems, extrapyramidal signs
and involuntary movements of the << alien hand >> type, The data conf
irm the presence of focal forms of Alzheimer's disease. The motor apra
xia seen in our patients resembles the kinesthesic apraxia described b
y Luria.