著者
原 貴敏 垣田 清人 児玉 万実 土井 孝明 安保 雅博
出版者
公益社団法人 日本リハビリテーション医学会
雑誌
The Japanese Journal of Rehabilitation Medicine (ISSN:18813526)
巻号頁・発行日
vol.51, no.3, pp.228-233, 2014 (Released:2014-05-10)
参考文献数
16

Alien hand syndrome (AHS) is a rare neurologic disorder in which movements are performed without conscious will. Cognitive rehabilitation is usually first considered for treating AHS. However, we proposed different modalities for the treatment. This is the first case report showing therapeutic effects of the NEURO-15 program that consists of low-frequency repetitive transcranial magnetic stimulation and intensive occupational therapy on AHS symptoms and upper limb dysfunction caused by a stroke one year and three months before. A 68-year-old male developed right upper limb palsy secondary to cerebral infarction on the medial side of the left frontal lobe. On admission, he exhibited disturbed skilled motor behavior, compulsive grasping of the right upper limb, and dissociated behavior of the right hand independent from the left. The right hand interfered with the actions executed by the left hand. The left hand restricted the right hand in its actions by holding it. Six months after the onset, his Activities of Daily Living improved and he was discharged from hospital to home. However, his compulsive grasping of the right upper limb symptoms remained, and he underwent NEURO-15 one year and three months after the onset. His right upper limb function improved. Compulsive grasping of the right upper limb disappeared, and the contradictory action of the right upper limb was rarely seen. These results suggested that NEURO-15 influenced the neural network including the primary motor cortex and supplementary motor area.
著者
浦部 博志 垣田 清人
出版者
公益社団法人 日本リハビリテーション医学会
雑誌
The Japanese Journal of Rehabilitation Medicine (ISSN:18813526)
巻号頁・発行日
vol.56, no.1, pp.23-27, 2019-01-18 (Released:2019-03-04)
参考文献数
8

失語症患者に対する経頭蓋磁気刺激治療は十分なエビデンスがあるとはいえないが,脳卒中による慢性期失語症患者に対して反復経頭蓋磁気刺激治療と集中的なリハビリテーション治療を行うことで,その効果が認められてきている.十分なエビデンスが得られない要因の1つに失語症自体が上肢麻痺に比べると複雑であり,かつ個々の症例ごとに異なる点がある.経頭蓋磁気刺激治療にあたっては,まず画像検査で機能的代償部位を評価し,個々に応じた刺激方法を選択する必要がある.今後は,症例を積み重ねていき,再検討することにより経頭蓋磁気刺激治療の有効性を高めていきたい.