Tuesday, April 7, 2015

Study group discussion: How to determine which hemisphere is dominant

Why do we ask about handedness in CNS case?

Dominant hemisphere and handedness http://medicowesome.blogspot.in/2014/12/dominant-hemisphere-and-handedness.html

Yup but in both LEFT is only dominant.. Then why bother asking?

There are exceptions where right hemisphere is dominant. Only 85% population has left dominant. 15% has right dominant.

I had seen a case in which the right hemisphere was dominant, in a right handed person!

How did you know she was right dominant?

We asked her to write, comb hair, thread needle -  She was right handed.

She was right handed I agree ...
But how to know her right side is dominant?

She was right handed through history and examination.
Had UMN type of hemiparesis on the left side, clinically (Right hemisphere affected)
She also had difficulty in comprehension and speech, clinically (Brocas area affected)
So Brocas is usually on the left side, the dominant, that is.
But in this case, since the right hemisphere was affected, her Brocas was on the right side.

Our professors said shift of hemisphere can occur in childhood injury. Which could be a reason.. But there was no history suggestive of such insult in our case.

If broca is not affected.. We cant comment on right or left dominance?

I guess. No idea.

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