右側頭葉内側部梗塞により健忘を呈した1例―その経過とリハビリテーション

Amnestic Syndrome Caused by Cerebral Infarction in the Right Medial Temporal Lobe―Case Report

はじめに

　脳血管障害による健忘症候群は，両側海馬を含む側頭葉内側部のほか，前内側視床や視床傍正中部，脳梁膨大部後域，脳弓，前脳基底部などの病変で生じることが知られている^1）。しかし，これらが両側性病変で起こるのか，一側性病変でもみられるのかは，一定の見解が得られていない。

　一方，記憶障害に対するリハビリテーションの治療内容やその効果についての報告はそれほど多くない^2）。今回われわれは，右側頭葉内側部梗塞により，記憶障害を呈した症例に対して，種々のリハビリテーションアプローチを実施したので報告する。

Abstract

　We report here a case of amnestic syndrome with executive dysfunction and attention deficit caused by cerebral infarction in the right temporal lobe was reported.　An 80-year-old, right-handed female with complaints of memory impairment, was admitted to our hospital.　She had neither motor paresis nor sensory disturbances.　She exhibited disorientation, retrograde amnesia, anterograde amnesia, executive dysfunction and attention deficit.　Although her immediate recall and remote memory were almost intact, her recent memory was moderately impaired.　Both verbal memory and non-verbal memory were impaired.　Brain MRI revealed cerebral infarction in the right temporal lobe involving the parahippocampal gyrus, and SPECT demonstrated low perfusion areas in both the cerebral hemispheres involving basal ganglia and the right thalamus.　After a 4-month rehabilitation program, her memory impairment improved considerably.　We consider that the reason that contributed to these improvement include the fact that her lesion was unilateral and that her executive dysfunction and attention deficit also improved.　This finding suggests that memory is related to attention and executive function.

(Received: November 22, 2006, Accepted: April 2, 2007)