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Morel's laminar sclerosis showing apraxia of speech: Distribution of cortical lesions in an autopsy case |
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| Authors: | Zen Kobayashi Kuniaki Tsuchiya Mafuyu Takahashi Osamu Yokota Kazuhiro Taki Hideki Ishizu Tetsuaki Arai Haruhiko Akiyama Hidehiro Mizusawa |
| Institution: | 1. Department of Neurology and Neurological Science, Graduate School, Tokyo Medical and Dental University, Tokyo,;2. Tokyo Institute of Psychiatry, Tokyo,;3. Department of Laboratory Medicine and Pathology, Tokyo Metropolitan Matsuzawa Hospital, Tokyo,;4. Department of Neurology, Ohme Municipal General Hospital, Tokyo,;5. Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama,;6. Department of Pathology, Musashino Redcross Hospital, Tokyo and;7. Department of Laboratory Medicine, Zikei Institute of Psychiatry, Okayama, Japan |
| Abstract: | A 57‐year old man with chronic alcoholism presented with apraxia of speech and disturbance of consciousness. He had a history of gastrectomy and had been drinking alcohol. The symptoms improved with administration of thiamine, but he later developed diarrhea and delirium, and died approximately 40 days after the onset. Autopsy findings were consistent with Wernicke's encephalopathy and pellagra encephalopathy. Furthermore, laminar cortical necrosis with vacuoles and astrocytosis was found in the second and third layers of the bilateral frontal cortices, suggesting Morel's laminar sclerosis. The lesions were mainly located in the bilateral primary motor cortices. Involvement of the lower part of the left primary motor cortex may be associated with apraxia of speech in our case. |
| Keywords: | apraxia of speech Morel's laminar sclerosis pellagra encephalopathy primary motor cortex Wernicke's encephalopathy |