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ATHETOSIS: II. SURGICAL TREATMENT OF UNILATERAL ATHETOSIS

ATHETOSIS: II. SURGICAL TREATMENT OF UNILATERAL ATHETOSIS Abstract In 1932 Buchanan and one of us (P. C. B.)1 reported a case (case 1) of unilateral (left) athetosis with spastic hemiparesis and unilateral convulsive seizures involving the left side which appeared two weeks after an uncomplicated tonsillectomy in January 1930. Two encephalograms, one made in May and the other in October 1931, revealed no abnormality that was considered significant. In November 1931, almost two years after the onset, the patient was operated on. The right central region was exposed. Electrical stimulation of the precentral gyrus in its middle portion elicited "complex movements of the left arm identical with those involuntary athetoid movements previously observed in the patient." This portion of the precentral gyrus was then extirpated. Microscopic examination revealed that the portion of cortex removed consisted almost entirely of area 6 of Brodmann. When the patient was last seen, on Nov. 13, 1935, it was stated that since References 1. Bucy, P. C., and Buchanan, D. N.: Athetosis , Brain 55:479-492, 1932.Crossref 2. Wilson, S. A. K.: Disorders of Motility and of Muscle Tone , Lancet 2:1-10, 53-62, 169-178, 215-219 and 268-276, 1925. 3. Our insertion. 4. The italics are ours. 5. Jakob, A.: Die extrapyramidalen Erkrankungen , Berlin, Julius Springer, 1923. 6. Levin, P. M.: The Efferent Fibers of the Frontal Lobe of the Monkey, Macaca Mulatta , J. Comp. Neurol. 63:369-419, 1936.Crossref 7. Recent studies in our laboratory (to be reported on later by Dr. Leon Ectors) of the brain of an adult human being damaged by prolonged ischemia revealed that the most marked changes were disintegration of the ganglion cells of the cerebral cortex, particularly in the anterior and posterior central gyri, and of the Purkinje cells of the cerebellum. The basal ganglia and brain stem showed no significant changes. 8. Bucy, P. C.: Electrical Excitability and Cyto-Architecture of the Premotor Cortex in Monkeys , Arch. Neurol. & Psychiat. 30:1205-1224 ( (Dec.) ) 1933. 9. Fulton, J. F.: Forced Grasping and Groping in Relation to the Syndrome of the Premotor Area , Arch. Neurol. & Psychiat. 31:221-235 ( (Feb.) ) 1934. 10. Gardner, W. J.: Removal of the Right Cerebral Hemisphere for Infiltrating Glioma , J. A. M. A. 101:823-825 ( (Sept. 9) ) 1933. 11. Dandy, W. E.: Removal of Right Cerebral Hemisphere for Certain Tumors with Hemiplegia: Preliminary Report , J. A. M. A. 90:823-825 ( (March 17) ) 1928 12. Physiological Studies Following Extirpation of the Right Cerebral Hemisphere in Man , Bull. Johns Hopkins Hosp. 53:31-51, 1933. 13. Bucy, P. C., and Fulton, J. F.: Ipsilateral Representation in the Motor and Premotor Cortex of Monkeys , Brain 56:318-342, 1933. 14. Walshe, F. M. R.: On the "Syndrome of the Premotor Cortex" (Fulton) and the Definition of the Terms "Premotor" and "Motor," with a Consideration of Jackson's Views on the Cortical Representation of Movements , Brain 58:49-80, 1935. 15. Vogt, O., and Vogt, C.: Allgemeinere Ergebnisse unserer Hirnforschung , J. f. Psychol. u. Neurol. 25:273-462, 1919. 16. Brodmann, K.: Vergleichende Lokalisationslehre der Grosshirnrinde in ihren Princizipien dargestellt auf Grund des Zellenbaues , Leipzig, J. A. Barth, 1909. 17. Foerster, O.: Ueber die Bedeutung und Reichweite des Lokalizationsprinzips in Nervensystem , Verhandl. d. deutsch. Gesellsch. f. inn. Med., Kong. 46, 1934, pp. 117-211. 18. Wilson, S. A. K., and Walshe, F. M. R.: The Phenomenon of "Tonic Innervation" and Its Relation to Motor Apraxia , Brain 37:199-246, 1914. 19. Adie, W. J., and Critchley, M.: Forced Grasping and Groping , Brain 50:142-170, 1927. 20. Bucy, P. C.: Areas 4 and 6 of the Cerebral Cortex and Their Projection Systems , Arch. Neurol. & Psychiat. 35:1396-1400 ( (June) ) 1936. 21. Bucy, P. C.: Frontal Lobe of Primates: Relation of Cyto-Architecture to Functional Activity , Arch. Neurol. & Psychiat. 33:546-557 ( (March) ) 1935 22. A Comparative Cyto-Architectonic Study of the Motor and Premotor Areas in the Primate Cortex , J. Comp. Neurol. 62:293-331, 1935. 23. P. C. Bucy and T. J. Case ( Cortical Innervation of Respiratory Movements , J. Nerv. & Ment. Dis. 84:156-168, 1936). 24. The Subpial Resection of the Cortex in the Treatment of Jacksonian Epilepsy [Horsley Operation] with Observations on Areas Four and Six , Brain 58:492-503, 1935 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology & Psychiatry American Medical Association

ATHETOSIS: II. SURGICAL TREATMENT OF UNILATERAL ATHETOSIS

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References (27)

Publisher
American Medical Association
Copyright
Copyright © 1937 American Medical Association. All Rights Reserved.
ISSN
0096-6754
DOI
10.1001/archneurpsyc.1937.02260170011001
Publisher site
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Abstract

Abstract In 1932 Buchanan and one of us (P. C. B.)1 reported a case (case 1) of unilateral (left) athetosis with spastic hemiparesis and unilateral convulsive seizures involving the left side which appeared two weeks after an uncomplicated tonsillectomy in January 1930. Two encephalograms, one made in May and the other in October 1931, revealed no abnormality that was considered significant. In November 1931, almost two years after the onset, the patient was operated on. The right central region was exposed. Electrical stimulation of the precentral gyrus in its middle portion elicited "complex movements of the left arm identical with those involuntary athetoid movements previously observed in the patient." This portion of the precentral gyrus was then extirpated. Microscopic examination revealed that the portion of cortex removed consisted almost entirely of area 6 of Brodmann. When the patient was last seen, on Nov. 13, 1935, it was stated that since References 1. Bucy, P. C., and Buchanan, D. N.: Athetosis , Brain 55:479-492, 1932.Crossref 2. Wilson, S. A. K.: Disorders of Motility and of Muscle Tone , Lancet 2:1-10, 53-62, 169-178, 215-219 and 268-276, 1925. 3. Our insertion. 4. The italics are ours. 5. Jakob, A.: Die extrapyramidalen Erkrankungen , Berlin, Julius Springer, 1923. 6. Levin, P. M.: The Efferent Fibers of the Frontal Lobe of the Monkey, Macaca Mulatta , J. Comp. Neurol. 63:369-419, 1936.Crossref 7. Recent studies in our laboratory (to be reported on later by Dr. Leon Ectors) of the brain of an adult human being damaged by prolonged ischemia revealed that the most marked changes were disintegration of the ganglion cells of the cerebral cortex, particularly in the anterior and posterior central gyri, and of the Purkinje cells of the cerebellum. The basal ganglia and brain stem showed no significant changes. 8. Bucy, P. C.: Electrical Excitability and Cyto-Architecture of the Premotor Cortex in Monkeys , Arch. Neurol. & Psychiat. 30:1205-1224 ( (Dec.) ) 1933. 9. Fulton, J. F.: Forced Grasping and Groping in Relation to the Syndrome of the Premotor Area , Arch. Neurol. & Psychiat. 31:221-235 ( (Feb.) ) 1934. 10. Gardner, W. J.: Removal of the Right Cerebral Hemisphere for Infiltrating Glioma , J. A. M. A. 101:823-825 ( (Sept. 9) ) 1933. 11. Dandy, W. E.: Removal of Right Cerebral Hemisphere for Certain Tumors with Hemiplegia: Preliminary Report , J. A. M. A. 90:823-825 ( (March 17) ) 1928 12. Physiological Studies Following Extirpation of the Right Cerebral Hemisphere in Man , Bull. Johns Hopkins Hosp. 53:31-51, 1933. 13. Bucy, P. C., and Fulton, J. F.: Ipsilateral Representation in the Motor and Premotor Cortex of Monkeys , Brain 56:318-342, 1933. 14. Walshe, F. M. R.: On the "Syndrome of the Premotor Cortex" (Fulton) and the Definition of the Terms "Premotor" and "Motor," with a Consideration of Jackson's Views on the Cortical Representation of Movements , Brain 58:49-80, 1935. 15. Vogt, O., and Vogt, C.: Allgemeinere Ergebnisse unserer Hirnforschung , J. f. Psychol. u. Neurol. 25:273-462, 1919. 16. Brodmann, K.: Vergleichende Lokalisationslehre der Grosshirnrinde in ihren Princizipien dargestellt auf Grund des Zellenbaues , Leipzig, J. A. Barth, 1909. 17. Foerster, O.: Ueber die Bedeutung und Reichweite des Lokalizationsprinzips in Nervensystem , Verhandl. d. deutsch. Gesellsch. f. inn. Med., Kong. 46, 1934, pp. 117-211. 18. Wilson, S. A. K., and Walshe, F. M. R.: The Phenomenon of "Tonic Innervation" and Its Relation to Motor Apraxia , Brain 37:199-246, 1914. 19. Adie, W. J., and Critchley, M.: Forced Grasping and Groping , Brain 50:142-170, 1927. 20. Bucy, P. C.: Areas 4 and 6 of the Cerebral Cortex and Their Projection Systems , Arch. Neurol. & Psychiat. 35:1396-1400 ( (June) ) 1936. 21. Bucy, P. C.: Frontal Lobe of Primates: Relation of Cyto-Architecture to Functional Activity , Arch. Neurol. & Psychiat. 33:546-557 ( (March) ) 1935 22. A Comparative Cyto-Architectonic Study of the Motor and Premotor Areas in the Primate Cortex , J. Comp. Neurol. 62:293-331, 1935. 23. P. C. Bucy and T. J. Case ( Cortical Innervation of Respiratory Movements , J. Nerv. & Ment. Dis. 84:156-168, 1936). 24. The Subpial Resection of the Cortex in the Treatment of Jacksonian Epilepsy [Horsley Operation] with Observations on Areas Four and Six , Brain 58:492-503, 1935

Journal

Archives of Neurology & Psychiatry – American Medical Association

Published: May 1, 1937

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