Spatial agraphia (空間性失書)症例に対するリハビリテーションと自然経過

概要

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Spatial agraphia is a non-aphasic writing disturbance due to a visuospatial impairment, and is characterized by the tendency to write only on the right side of the page in relation to left unilateral spatial neglect (USN), and to omit or duplicate strokes. We experienced three cases of spatial agraphia, and compared the results of our rehabilitation intervention for one patient with its natural course in the other two patients. The patient who underwent rehabilitation intervention is a right-handed 52-year-old man with left hemiparesis, USN and spatial agraphia following traumatic brain injury. We asked him to do a numbering exercise (counting strokes during writing). After that, his stroke errors reduced considerably in number. From the starting point to the finish of rehabilitation intervention, his USN was mild 〜 moderate and unchanged. In contrast, the two patients whose outcomes followed a natural course kept making stroke errors 3 years after their brain attacks in spite of the alleviation of their USN, which had been mild 〜 moderate at the onset of their syndromes. It is suggested that spatial agraphia is not directly related to USN, while USN makes the disorder worse. We assume that the numbering exercise might make it easier for the patient to compare the number of strokes specified at the motor program level with the actual number of movements already realized.
2006-05-18