We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Images in Neurology |

Evaluation of Functional Cortex for the Diseased Hand in a Patient After Hemispherectomy

Jakob Rath; Robert Schmidhammer, MD; Thomas Steinkellner; Nicolaus Klinger, MSc (FH); Alexander Geissler, MSc; Roland Beisteiner, MD, MA
Arch Neurol. 2008;65(12):1664-1665. doi:10.1001/archneur.65.12.1664.
Text Size: A A A
Published online


A 27-year-old man presented with increased motor deficits of the paretic left arm. The patient had an infarction of the right middle cerebral artery territory at 2 years of age and underwent functional hemispherectomy at 11 years (owing to intractable generalized epilepsy). The patient was transferred for reevaluation of his left arm's motor functions and possibly new central motor deficits. History revealed considerable recovery of hand motor function after the stroke and worsened hemiparesis after hemispherectomy, but secondary improvement of hand function after physiotherapy and orthopedic surgical procedures. On examination, the patient had spastic hemiparesis but voluntary control and sustained weak motor function of the hemiparetic left arm. Active fist clenching and full extension-flexion of the elbow joint were possible. Motility was somehow limited owing to contractures. Anatomical magnetic resonance imaging (MRI) showed no pathological findings in the remaining left hemisphere.

Figures in this Article



Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview


Place holder to copy figure label and caption

Functional echoplanar imaging originals (t > 12) showing activation in 3 slices covering the hand motor area (top row is most superior slice). A, Contralateral healthy hand activation shown in blue. B, Ipsilateral paretic hand activation shown in orange. C, Activation in both hands.

Graphic Jump Location




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

2 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Psychological growth after childbirth: an exploratory prospective study. J Psychosom Obstet Gynaecol Published online Sep 20, 2016;
Developing an evidence-based transition program for graduate nurses. Contemp Nurse Published online Sep 20, 2016;

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis