脳卒中後Alien hand syndromeを呈した症例に対する身体意識に着目した介入の試み

Approaches focusing on body consciousness of alien hand syndrome in stroke patients: A case report

要旨：Alien hand syndrome（AHS）は，他人の手徴候や強制把握，道具の強制使用，拮抗失行などの症状があり，これらは疾患や病巣によりさまざまである．AHSに対し明確なリハビリテーションは確立されていない．近年，中枢神経障害の病態解釈において自己の身体意識に含まれる運動主体感（SoA）や身体所有感（SoO）が着目され，AHSでもSoAとSoOの低下が示唆されている．今回，AHSの症状や情緒の不安定により日常生活動作（ADL）が阻害された症例に対し，身体意識に着目した介入を行った結果，症状が消失しADLの自立度が向上した．AHSに対し身体意識に着目した介入が有効である可能性が示唆された．

　Alien hand syndrome (AHS) includes signs of stranger hand signs, forced grasping, forced use of tools, and antagonistic apraxia, which vary by disease and foci. No clear rehabilitation for AHS has been established. In recent years, the Sense of Agency (SoA) and Sense of Ownership (SoO), which are included in the body consciousness of the self, have been focused on in the pathological interpretation of central nervous system disorders, and a decrease in SoA and SoO has also been reported in AHS. In the present study, we conducted an intervention focusing on body consciousness in a patient with AHS, whose activities of daily living (ADL) and emotions were inhibited by AHS. As a result, the symptoms disappeared, and the level of independence in ADL improved. The results suggest that interventions focusing on body consciousness may be effective for AHS.