眼球運動訓練により生活の不自由度が改善した脳幹梗塞の1例

Improvement of disturbance through oculomotor training in the daily life of a patient with brainstem infarction

要旨：眼球運動障害により，日常生活に大きな不自由を認めた70歳代女性の脳幹梗塞症例に対し，眼球運動訓練を実践したため報告する．症例は，右眼に内転障害を呈し，左方視で複視を認めた．テレビを見る，字を書くなど生活動作に重度の不自由を感じていた症例に対し，頭位変換を伴わない追視，注視，輻輳反射を用いた眼球運動訓練を週6回，1回20分，期間は4週間実施した．その結果，眼球運動は改善し，複視は消失，生活の不自由度も著明に改善した．眼球運動訓練により，外眼筋の短縮や萎縮などの二次的な変化を予防できたことが，良好な結果につながったと考える．

　We report on a case of oculomotor training in a woman in her 70s who presented mild oculomotor disorders and disturbance in daily life caused by brainstem infarction. The patient suffered from diplopia due to an adduction disorder of the right eye. She felt disturbance in watching television, writing and other tasks. Her oculomotor training consisted of pursuit, fixation, and convergence reflex, and was performed for 20 minutes, six times a week for 4 weeks. As a result, her oculomotor improved, diplopia disappeared, and disturbances in daily life improved significantly. The oculomotor training prevented secondary changes such as shortening or atrophy of the extraocular muscle.