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Micrographia and Abulia due to Frontal Subcortical
Infarction
Kengo Maeda, Ryo Idehara and Tomoyuki Shiraishi
Key words: micrographia, abulia, infarction, frontal lobe function
(Intern Med 51: 1953-1954, 2012)
(DOI: 10.2169/internalmedicine.51.7721)

Picture

A right-handed 85-year-old man with diabetes and hypertension presented with abrupt onset micrographia and loss of
interest in reading books. He was alert and there was no
hemiparesis, extrapyramidal sign, sensory disturbance of fingers, or ataxia. There was no alexia or agraphia. His diary
clearly showed micrographia after the onset day (Picture).
Diffusion-weighted magnetic resonance imaging revealed a
fresh infarction at the left frontal subcortex extending to the
anterior limb of the internal capsule and the head of the
caudate (Picture). His symptom was considered to be micrographia and abulia. Lesions affecting the frontal subcortex are known to cause micrographia (1). The frontal lobe

function could play a role in the pathogenesis of micrographia (1, 2). The fact that the presented case showed
not only micrographia but also abulia might support the possible link of frontal lobe function and micrographia.
The authors state that they have no Conflict of Interest (COI).

References
1. Nakamura M, Hamamoto M, Uchida S, et al. A case of micrographia after subcortical infarction: possible involvement of
frontal lobe function. Eur J Neurol 10: 593-596, 2003.

Department of Neurology, National Hospital Organization Shiga Hospital, Japan
Received for publication March 12, 2012; Accepted for publication May 7, 2012
Correspondence to Dr. Kengo Maeda, maeda-kengo@shiga-hosp.jp

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Intern Med 51: 1953-1954, 2012

DOI: 10.2169/internalmedicine.51.7721

2. Troyer AK, Black SE, Armilio ML, Moscovitch M. Cognitive and
motor functioning in a patient with selective infarction of the left

basal ganglia: evidence for decreased non-routine response selection and performance. Neuropsychologia 42: 902-911, 2004.

Ⓒ 2012 The Japanese Society of Internal Medicine
http://www.naika.or.jp/imindex.html

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