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Asymmetric catalepsy after right hemisphere stroke
J L Saver1, P Greenstein, M Ronthal
1Department of Clinical Neurosciences, Rhode Island Hospital, Providence.
Summary
Right hemisphere stroke can cause asymmetric catatonia, specifically left hemineglect and catalepsy. This case highlights the link between right parietal lobe lesions and motor abnormalities, challenging previous understandings of catatonia.
Area of Science:
- Neuroscience
- Neurology
- Clinical Medicine
Background:
- Catatonia is a complex neuropsychiatric syndrome characterized by motor abnormalities.
- Previous research suggests lesions in various brain regions, including the frontal lobe, limbic system, diencephalon, or basal ganglia, can cause catatonia.
- However, asymmetric presentations and specific links to right hemisphere lesions are less understood.
Observation:
- A patient presented with left hemineglect and pronounced left-sided cataleptic posturing.
- The patient had no prior psychiatric history.
- Neuroimaging revealed a significant infarct in the posterior right hemisphere, affecting the parietal, occipital, and temporal lobes, insula, and caudate nucleus.
Findings:
- The patient exhibited catalepsy and hemineglect but lacked other features of the full catatonia syndrome, such as stereotypy or mutism.
- This case demonstrates that a large right hemisphere infarct can lead to asymmetric cataleptic posturing.
- The findings partially support existing literature associating catalepsy with parietal lobe involvement.
Implications:
- This case expands the understanding of focal brain lesions causing specific catatonic symptoms.
- It suggests that the right hemisphere, particularly the parietal lobe, plays a crucial role in motor control and posture.
- Further research is warranted to explore the neural mechanisms underlying asymmetric catatonia and its relationship to hemispheric lateralization.