急性期の複視に対する視覚と体性感覚の統合機構へ治療介入を実践した脳幹梗塞の1例

Therapeutic intervention for brainstem infarction to integrate vision and somatosensory for diplopia in the acute phase: A case study

要旨：複視により，麻痺眼不使用を認めた70代男性の急性期脳幹梗塞例に対し，視覚と体性感覚の統合機構への治療介入を実践したため報告する．症例は，右眼（麻痺眼）に内転障害を呈し，左方視で複視を認めた．麻痺眼に眼帯使用など片眼遮断にて生活を行っていたが，歩行などに生活の不自由を感じていた症例に対し，上肢運動覚と視覚の統合を用いた治療介入を週5回を限度として，1日20分，期間は9日間実施した．その結果，両眼使用での生活が可能になり，生活の不自由度も改善された．両眼使用により，（麻痺眼）外眼筋の短縮や萎縮など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 a case of acute brainstem infarction in a male in his 70s with diplopia who practiced a therapeutic intervention in the integrated mechanism of vision and somatosensory resulting in no paralyzed eyes. The case presented with adduction disorder in the right eye (paralyzed eye) and diplopia in the left eye. The patient lived with one-eye blockage such as using an eye patch for paralyzed eyes, experienced inconvenienced in walking. Treatment intervention using upper limb motor sensation and visual integration was performed up to 5 times a week, 20 minutes per day for a period of 9 days. As a result, it became possible to live with both eyes, and the degree of inconvenience in life was reduced. We believe that the use of both eyes prevented secondary changes such as shortening and atrophy of the extraocular muscles (paralyzed eye), which led to good results.