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Brain, Vol. 118, No. 6, 1365-1374, 1995
© 1995 Guarantors of Brain

research-article

Subcortical origin of visuomotor apraxia

J. Classen1, E. Kunesch1, F. Binkofski1, F. Hilperath1, G. Sehlaug1, R. J. Seitz1, M. Glickstein2 and H.-J. Freund1,

1Department of Neurology, Heinrich-Heine-Universität Düsseldorf Germany 2Department of Anatomy and Developmental Biology, University College London UK

Correspondence to: Correspondence to: Professor H.-J. Freund, Neurologische Klinik der Heinrich-Heine-Universität Düsseldorf, Germany

Visuomotor apraxia (VMA) is a clinical syndrome characterized by a failure to make use of visual information when performing a target-directed movement. Visuomotor apraxia has traditionally been assumed to result from a disconnection of cortico-cortical fibres between visual and motor areas following occipito-parietal lesions. We describe a patient who developed a permanent contralesional and a temporary ipsilesional visuomotor apraxia as part of a complex neurological syndrome after a left thalamic haemorrhage. MRI showed that the suprathalamic white matter was not involved but the most caudal fibres of the internal capsule appeared to be interrupted. To our knowledge this is the first case of a VMA with a lesion restricted to a deep subcortical area indicating that VMA can result from damage to subcortical projections rather than interruption of cortico-cortical fibres.

visuomotor ataxia; visuomotor apraxia

Received April 26, 1995. Revised July 7, 1995.
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