運動無視（négligence motrice,Casteigne）を呈した脳腫瘍の1例

MOTOR NEGLECT (NÉGLIGENCE MOTRICE) OF CASTEIGNE:REPORT OF A CASE

　26歳の右利きの男で，昭和46年5月始めより頭痛を認め，その後右の粗大力低下と言語障害を訴え，6月2日に金沢大学脳神経外科に入院した．右半身のごく軽度の知覚運動障害，運動失語，失算のほか，右半身に次のような特徴的な行為の障害を呈した。すなわち，患者は「右の手足が動かない」と信じており，右上下肢の無使用，忘却が顕著であつた。命令ならびに激励により行為は一応可能であるが，遅鈍で不確実で，粗大な動作の完成がとくに困難であつた。6月8日に手術をおこない，左中心領白質より直径3．5cmの腫瘍組織を剔除した。

　本症例に見られた行為の障害は，最近Castelgneら^3）（1970）が「運動無視négligence motrice」の名の下に報告した症状とほぼ完全に一致する。本症状に関して若干の考察を加えた。

A right-handed man, aged 26, showed a motor or praxic disorder localized to the right hemi-body, besides motor aphasia, acalculia and very slight sensori-motor disturbances of the right hemi-body. The motor or praxic disorder of this patient consist-ed of paucity of movement : both upper and lower extremities of the right side were hardly utilized spontaneously or imperatively, since he believed that the extremities of the right hemi-body was paralysed almost completely. Although movements could be realized by instructions and incessant en-couragements, they were slow and clumsy and completion of some grand gestures was disturbed.

On operation, a tumor of 3.5cm in diameter was found in the white matter under the precentral gyrus and was resected with the superficial cortical grey substances.

The unilateral dyspraxia of this patient was the same as was reported by Casteigne et al. (1970) under the label "motor neglect". Unilateral dys-praxia and "motor neglect" were discussed.