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Although disorders in the use of single objects have been reported, there have been few detailed analyses. We describe the autopsy case of a 65-year-old, right-handed male patient with severe impairment of actual tool use which was caused by biparietal infarctions. He persistently and stably showed a severely defective use of actual objects, single or multiple, and relatively well-preserved pantomimes of object use and intransitive gestures. He did not have aphasia or dementia, and his ability for tool naming and function description was completely preserved. The author identified similar patterns of errors about a tool-action(-target) relationship both in single-object use and multiple-object use. Lesion analysis showed cortical infarcts mainly located in the bilateral inferior parietal lobules, extending into the temporal lobe on the right side.Copyright © 2003 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

We report a 72-year-old right-handed man who showed an ‘apraxia of tool use’ after a cerebral infarct in the territory of the left middle cerebral artery. His apraxia of tool use was characterized by a clear dissociation between the inability to use a single tool and the ability to use plural tools. Most of the errors occurred in selecting an appropriate target where a tool is expected to be applied. Detailed examinations confirmed that his conceptual knowledge of tool use was well preserved. Furthermore, when a target of a tool was provided as a cue, he used a single tool correctly. These results suggest that his inability to use a single tool originated from his inability to evoke a target image from an actual tool.Copyright © 2000 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]