PROGRESSIVE WORSENING LEFT UNILATERAL APR AXIA IN 2 CASES OF ALZHEIMERS-DISEASE

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.