相貌失認と劣位半球症状群を呈した脳血管障害の1症例

A CASE OF CEREBRAL VASCULAR DISEASE ASSOCIATED WITH PROSOPAGNOSIA AND MINOR HEMISPHERE SYNDROME

I．はじめに

　相貌失認は，よく知つている人の顔の認知ができない状態であり，その基本障害は必らずしも確定的ではなく，Benton^5）は記憶または連想の障害の限定されたタイプと考えるのが最も妥当であると述べている。

　われわれは，最近，劣位半球の症状群と相貌失認を示す症例を経験した。本症例では「知らない顔」の弁別は可能であるが，その記憶に障害があることを認め，相貌失認の基本障害を考える上に興味のある症例であると思われたので"apractognosia"として表現される劣位半球症状群の考察とともに報告しておきたい。

A case of "apractognosia", a syndrome of minor hemisphere, and prosopagnosia was described.

A 68 years old, right handed, hypertensive man who had experienced an episode of left hemiparesisof several weeks' duration developed a syndrome of minor hemisphere, metamorphopsia, visuocon-structive disability, spatial dysgraphia, topographical and geographical disorientation and dressing apraxia, with associated left homonymous hemianopsia.

A right occipital lesion was disclosed by an iso-topic brain scan and a CT scan. The CT scan also disclosed a generalized cerebral atrophy.

Memory disturbance, both verbal and visual, was observed. Verbal memory was examined by coupled words test, digit span and 10-words learning test, and visual memory by spatial pointing span and memorizing unfamiliar faces. The patient was able to differentiate unfamiliar faces, but was not able to memorize them correctly.

Although the patient has complained of a dis-turbance of recognizing familiar faces (prosopag-nosia), but actually, sometimes he was able to rec-ognize the members of his family by the faces and sometimes he was not. He has stated that he could not recall familiar faces.

The authors suggested prosopagnosia is, as Benton (1975) has supposed, considered to be the limited disorders of memory and association.