13 下列何類中樞神經疾病患者併發意念型失用症（ideational apraxia）的可能性最高？
(A)失智症（dementia）
(B)右半腦後側區域腦腫瘤
(C)左半腦後側血管病變
(D)下皮質受損之創傷性腦傷

(C)左半腦後側血管病變-->題幹中的後端應該是指PCA 而ideational apraxia是涉及ACA及MCA，故不能選(C)

排除之下只能選(A)了

參考書目：
Walsh, K. W., & Darby, D. (1999). Neuropsychology: A Clinical Approach: Churchill Livingstone.
Ch3. Elements of neurology--Disruption of higher cerebral functions, p99.
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引用部分內文

Ideationai apraxia is the difficulty in executing the correct sequence of steps

which makes up a complex act though the individual component acts may be

successfully carried out. It is a disruption of the total programme of the

required acts. Patients may show no difficulty in imltating sequences,

i.e. where the programme is provided for them.

Ideational apraxia is associated with dominant hemisphere parietal lobe

lesions and is thus often accompanied by fluent aphasia and elements of

Gerstmann's syndrome .Ideational apraxia is also seen with bilateral lesions.

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總結：流暢型失語症的缺損常出現在左腦的wernicke區， Gerstmann's syndrome最早發現在左頂葉的中風患者身上， 具體位置約在角迴(angular gyrus)，綜合兩者判斷，答案最接近C。

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PS. 109-2臨床心理特論二14題就是考Gerstmann's syndrome的併發症。

Alzheimer's disease showed maximum association with apraxias in all the phases of the disease ideational, ideomotor, dressing and constructional apraxias early and buccopharyngeal and gait apraxia late. Frontotemporal lobe dementia showed buccopharyngeal and gait apraxias late into the disease. Cortical basal ganglionic degeneration showed limb apraxias and diffuse Lewy body disease showed more agnosias and less apraxias common apraxias seen was Ideational and Ideomotor.

Apraxias in Neurodegenerative Dementias

Sadanandavalli Retnaswami Chandra, Thomas Gregor Issac,1 and Mirza Masoom Abbas