A case of echopaligraphia following cerebrovascular disease

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  • 反響反復書字を呈した脳血管障害の１例

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Abstract

   We report a case of echopaligraphia following subarachnoid hemorrhage caused by rupture of a right middle cerebral aneurysm. The patient was a right-handed 46-year-old male. Echographia was first reported by Pick in 1900 and was classified into auditory echographia, which noted spoken sounds, and optic echographia, which copied visual characters (Sittig 1928) . Auditory echographia and optic echographia were observed in this case and were combined with paligraphia (repeating the characters that the patient himself had written) ; i. e., the subject presented echopaligraphia. He also exhibited various neuropsychopathic symptoms (grasping phenomenon, utilization behavior, stereotypy behavior, hypermetamorphosis, etc.) . Forty-three days after his stroke, brain CT scans revealed a low-density area in the frontal and anterior temporal lobes in the right hemisphere, as well as enlargement of the third ventricle and lateral ventricles on both sides. <br>   The characteristics of echopaligraphia in this case were as follows. (1) Echopaligraphia was transient, and the appearance of echopaligraphia changed during the progression of hydrocephalus that aggravated his consciousness disorder. (2) In echolalia, the echo-forms of complete echolalia, mitigated echolalia and partial echolalia have been reported (Hadano et al. 1987) . Echographia in this case exhibited echo-forms that were similar to echolalia. (3) Echographia changed as follows : complete and mitigated echographia (fcomplete and mitigated and atypical echographia (atypical and partial echographia. (4) In the paligraphia of the current case, only slight repetition was observed quantitatively at first, but it increased in repetitions later and decreased thereafter. This report describes the case in detail and discusses the symptomatological characteristics, the appearance aspects and the neuropsychological mechanisms of echopaligraphia.

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