The occipital The occipital lobes Occipital lobe - Mahidol University

23/06/54Integrity of the kinesthetic basisof movement.Impairment of this component, orafferent apraxia, is usually due to alesion in the post-central gyruscontralateral to the impaired sideof the body.Movements tend to be awkward ordiffuse in character.Integrity of the kinesthetic basisof movement (cont).TestCheck basic sensory adequacy;then witheyes closed place patient's hand in oneposition and ask him to reproduce theposition with the other hand; ask patient toreproduce position of examiner's hands orfollow verbal commands for hand positionwithout looking at his own.NEUROPSYCHIATRY 151NEUROPSYCHIATRY 152Integrity of motor or dynamic basisof movement.Impairment of this component, or efferent apraxiais due to lesions of the premotor area, especiallyin the dominant hemisphere. It results inperseverative movements and the loss ofcontinuity i of movement.Test -- tasks requiring reciprocal coordination ofboth hands, alternating tapping patterns, ring-fisttest, fist-edge-palm test, and drawing ofalternating designsWord fluencyHas come to be associated with the leftfrontal area due to its disturbance withlesions in this region. It is hypothesizedthat the left hemisphere is necessary forverbal facility and the frontal area for theability to switch sets.Test -- have patient write or say as manywords as possible that begin with a givenletter in a given time period .NEUROPSYCHIATRY 153NEUROPSYCHIATRY 154Severe memory deficitsHave been reported with bilateral temporallesions and these have been thought to bedue to hippocampal damage.However, recently damage to temporal stemhas been postulated to produce severelearning and retention deficits in thepresence of intact hippocampi.Severe memory deficitsTest -- memory for verbal story, hiddenobjects, design reproduction frommemory, paired associates, andmemory for four unrelated wordsafter interference.NEUROPSYCHIATRY 155NEUROPSYCHIATRY 15626