呼吸リハビリテーション患者で著明な高次脳機能の改善をみた1症例

概要

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This paper reports a case of a 71-year-old COPD patient with neuropsychological impairment and with marked improvement of this impairment. The patient was diagnosed as chronic pulmonary emphysema ten years ago. He began to have hypoxia at the age of 61. At 65 years old, he had severe dyspnea on exersion and started to have oxygen. He complained of progressive exertional dyspnea and underwent an operation for lung volume reduction surgery. He also underwent pulmonary rehabilitation for 4 weeks before and after surgery. He was suspected of having memory impairment and attention disorder when he was referred to rehabilitation. He underwent neuropsychologic test and magnetic resonance image (MRI) for brain. The neuropsychologic test showed general cognitive impairment, attention disorder and verbal memory impairment. MRI showed moderate atrophy of left hippocanpal area and brain cortex, and lacunae infarction in periventricular area. Interestingly, scores of the neuropsychologic test as well as lung function and dyspnea remarkably improved 6 months after LVRS. These results suggested that the neuropsychological impairment in COPD patient could be improved if the patient's lung function improves. Further studies are needed to elucidate the relationship between neuropsychological impairment and chronic hypoxemia in a large number of patients. (Jpn J Rehabil Med 1999;36:489-492)
社団法人日本リハビリテーション医学会の論文
1999-07-18