Upper and lower face apraxia: role of the right hemisphere

The aim of this study was to evaluate face apraxia in left- and right-hemisphere-damaged patients both in the acute and chronic stage of their disease. Two newly devised tests that assess movements of the upper and lower face districts were employed. On the whole, the proportion of left-hemisphere-damaged patients showing face apraxia were 46 and 68% for upper and lower face, respectively. A substantial proportion of right-hemisphere-damaged patients also showed face apraxia, i.e. 44% upper face and 38% lower face. Concomitant variables such as general severity, locus of lesion, language or visuo-spatial impairments, presence of neglect, interval from stroke, peculiarity of clusters of items or scoring procedures did not account for these results. These findings suggest that face apraxia in some patients may affect movements of the upper face district and that the right hemisphere plays a significant part in both upper and lower face praxis.