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低酸素脳症により前頭葉性歩行失行を呈した1例を報告した。症例は34歳,女性。WPW症候群による心室性頻拍発作で低酸素脳症となり,その後歩行失行が出現した。Foot grasp reflex, Gegenhaltenなどの前頭葉症候と123I-IMP SPECTにて前頭葉内側を中心とする血流低下を認め,前頭葉性歩行失行と診断した。
Droxidopaによる明らかな改善を認めず,約7カ月後自然経過にてfoot grasp reflexの軽減とともに独立歩行が可能になった。これまで低酸素脳症による前頭葉性の歩行失行の病態は注目されておらず,本例はfoot grasp reflexが歩行失行の発現に重要と考えられた。
We reported a rare case who had hypoxic-ence-phalopathy causing frontal apraxia of gait. The patient, a 34-year-old female, was admitted in July, 1994, complaining of difficulty in walking after anoxic brain damage caused by ventricular arrhyth-mia. She had difficulty in raising her feet, which appeared to be rooted to the floor. There was no evidence of motor paralysis, spasticity, rigidity or sensory loss, but she did show frontal lobe signs such as foot grasp reflex and Gegenhalten. Cranial MRI showed slight atrophy of the frotal lobe.
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