Ideomotor apraxia has been defined as a failure to produce either a correct movement on verbal cornmand or to imitate correctly a movement performed by the examiner when the incorrect performance cannot be explained by weakness, incoordination, akinesia, abnormal reflexes, impaired auditory comprehension, or impaired visual or tactile perception.1 This had led to the conclusion that ideomotor apraxia is an inaccurate term to associate with Parkinson's disease because the patients manifest motor deficits.2With regard to the examination of motor behaviour the distinction between apraxic errors and lower level deficits of motor control has been expressed as follows: "The diagnosis of ideomotor apraxia is not made if a patient fails to carry out certain movements at all, nor is mere clumsiness of movement sufficient to consider a patient apraxic. The diagnosis is made when a patient is impaired in the proper selection of the motor elements which constitute a movement and in the correct ordering of these elements in a motor sequence".

No abstract

It was the purpose of the present study to quantify the expected motor deficit in parkinsonian patients with the computer assisted Motor Performance Test Series (MPS), version 05.87 by Schuhfried (1987) and to examine which of the motor test variables found correlate at a significance level of p less than 0.01 with items of "motor examination" recorded at neurological examination and "activities of daily living" of the Unified Parkinson's Disease Rating Scale (UPDRS), version 3.0. 38 patients with idiopathic Parkinson's disease (PD) stages I-IV according to Hoehn and Yahr, aged 41 to 73 years were studied. The study design, i.e. initial rating by the physician followed immediately by testing of motor function with MPS was strictly adhered to in each patient. Physician's rating of rigor and the scores of the semiquantitative tests (finger taps, hand movements and alternating movements) as expression of hypokinesia and the "activities of daily living" correlated with the 3 factors of the Motor Performance Test Series at a highly significant level independent of disease stage. Tremor is only partly and never significantly reflected in the motor data measured. Stages I-II and II-IV (Hoehn and Yahr) differ significantly in the representative data of the Motor Performance Test Series. The results of the study support the assumption that MPS is a valid instrument for quantitative measurement of the motor deficit in parkinsonian patients, but that only some subtests are "pathognomonic".

We report on three patients who presented a rare, uniform clinical syndrome consisting of ocular flutter and truncal ataxia. In all patients the symptoms followed an upper respiratory infection and resolved without sequelae within a few weeks. Previous reports have emphasized the apparent relationship of this entity to infectious disease, but the infectious agent remained uncertain. In one patient we could find a significant rise in antibody titres to enterovirus. We are not aware of any other similar documented case.

Within a period of 13 months a 24-year-old male student experienced four attacks of subarachnoid haemorrhage. An intradural-extramedullary haemangioma at the level of the second thoracic segment was found to be the cause of the repeated bleeding.