視覚認知機能障害を呈した認知症 : 視覚情報処理と視覚性注意を考える(神経内科学教室岩田誠教授退任記念特別号)

概要

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A 65-year-old with solvent exposure for 30 years had progressive memory disturbance from December 2000 and was admitted twice to our hospital. He first received interferon a and then imatinib mesilate for chronic myelogenous leukemia. He had difficulty drawing, copying, reading and writing. When he read and copied, he recognized the subject matter as separate fragments, and the whole was guessed at from the fragments. These clinical features were thought to correspond to apperceptive visual agnosia. We diagnosed him with Alzheimer Disease because of the slow clinical course and absence of acute mental defects, as characteristic of interferoninduced dementia. In visual analysis his visual attention focused not on whole images, but on parts. His range of visual attention became extremely narrow and consequently he recognized an image from its parts, and not as a whole. The correct location of each part in the whole was also incorrectly identified, and from the parts he came up with an incorrect impression of the whole picture that high familial memory inspired. The wrong visual impression was expressed and not compared with the subject. Thus, the dysfunction in his visual attention profoundly affected the abnormality of his visual processing.
2008-02-25