視覚性運動失調例に対する視覚運動課題の適応―到達運動誤差の定量的評価と経過─

Treatment of visuomotor tasks in a patient with optische ataxia and ataxie optique: Quantitative evaluation of reaching distance using the target point and actual touch point

要旨：我々の報告は左後頭頭頂葉を中心とした脳梗塞によりoptische ataxia（以下，OA）とataxie optique（以下，AO）を呈した症例に対し，注視下と周辺視野下の2条件下において到達運動誤差を定量的に評価し，視覚運動課題を実施したものである．症例は，発症後1ヵ月の54歳の男性患者で2条件下ともに，右方向への到達運動誤差が大きかったため，2条件下で点線図のなぞり課題や8の字軌道追従課題を実施した．6週間の訓練後，OAは右方向で12mmから6mmに，AOは右方向で80mmから27mmに改善した．入院時にできなかった，指定された位置に字を書くこと，包丁で野菜を切ることが可能になった．

　This is case study suggests the importance of evaluating reaching errors as ataxie optique (AO) and optische ataxia (OA), and planning visiomotor task training in both conditions.

　A 54-years-old male patient with both OA and AO due to a cerebral infarction in the left occiput-parietal lobe was admitted one month after onset.

　The patient presented significant reaching movement errors to the right direction. Tracing on target figures in the central condition and tracing figure-eight on the target was repeated 100 laps a day using a computerized motor-skill arm analyzer in two conditions: central vision for OA and the peripheral vision for AO. After training for 6 weeks, the reaching errors in OA decreased from 12mm to 6mm in the right direction. Reaching errors in AO also decreased from 80mm to 27mm in the right direction.

　The patient worked as a chef, but he could not cut vegetables with the kitchen knife because of difficulties in adjusting the knife to the direction of the vegetables. He also could not write characters in an appointed space. As OA and AO improved, he showed improvements in both tasks.