A Case Study Employing a Method of Written Expression of Oneʼs Position Relative to Surroundings, Making Reference to an Egocentric Reference Frame

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  • Kai Shogo
    Beppu Rehabilitation Center.
  • Nomura Shin
    Beppu Rehabilitation Center.
  • Nakashima Keiko
    Department of Clinical Psychology, Faculty of Clinical Psychology, Kyoto Bunkyo University
  • Yoshikawa Kosei
    Beppu Rehabilitation Center. Department of Rehabilitation, Onga Nakama Medical Association Okagaki Hospital

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  • 地誌的見当識障害の代償手段の検討─環境に対する自己の方向定位を記述したメモが有用であった 1 例─

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Abstract

<p>  One month after onset of a recent stroke, a woman in her late 60s was admitted to the convalescent rehabilitation ward of our rehabilitation center presenting with obvious topographical disorientation. Brain magnetic resonance imaging demonstrated right-sided cerebral infarctions involving the parahippocampal gyrus, fusiform gyrus, basal ganglia, superior parietal lobule, and retrosplenial region. Even after one week in hospital, the patient showed difficulty in moving from her room to the dining room or training room, despite their being connected by a straight corridor. The conventional neuropsychological evaluation revealed heading disorientation and landmark agnosia, and the Card Placing Test (CPT) devised by Hashimoto et al. (2016) additionally disclosed coexistence of egocentric disorientation. Accordingly, to compensate her topographical problems, we introduced a strategy using memos describing in words the spatial orientation of environmental items based on the patientʼs egocentric reference frame (e.g. “the AED is behind to the right” and “the counter is behind to the left”) . After 5 weeks of training using the spatial orientation memos, she was able to move independently throughout the hospital ward. Adding a test of egocentric disorientation, such as CPT, may contribute to elucidating the problems underlying topographical disorientation and gaining clues for rehabilitation methods.</p>

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