同名半盲と半側空間無視の鑑別における対座法視野検査の有用性

Usefulness of confrontational visual field test to differentiate homonymous hemianopia from hemispatial neglect

要約　目的：同名半盲と半側空間無視を鑑別する際での対座法の有用性の報告。症例：同名半盲として紹介された55歳と79歳の男性。1例には脳出血，他の1例には脳梗塞の既往があった。結果：1例にはGoldmann視野検査，他の1例にはHumphrey自動視野検査で左同名半盲があった。2例とも正面視での対座法による視野検査では左同名半盲があったが，身体を正面位にして右方視した状態では半盲はなかった。精神神経学的な異常と合わせ，半側空間無視と診断した。結論：動的静的視野検査では同名半盲と半側空間無視の鑑別が困難であり，対座法が有用である。

Abstract.　Purpose：To report the usefuness of confrontation test in the differential diagnosis between homonymous hemianopia and hemispatial neglect. Cases：This study was made on 2 males aged 55 and 79 years respectively. They had the history of cerebral hemorrhage and cerebral infarction respectively. Findings：Left homonymous hemianopia was present in both cases, after Goldmann perimetry in one and Humphrey automated perimetry in the other. By confrontation test, both cases showed left homonymous hemianopia while looking forward. Hemianopia was absent while the eyes were directed to the right. Both cases were diagnosed with hemispatial neglect. Conclusion：Confrontation test is useful to differentiate homonymous hemianopia from hemispatial neglect, when kinetic or static perimetry give inconclusive findings.