Abstract
A case of compulsive manipulation of tools (CMT) with left unilateral spatial neglect (USN) was reported. The patient was a 74-year-old right-handed male who had suffered from a stroke with occulsion of the left anterior cerebral artery and the right middle cerebral artery. Brain CT scan revealed a lesion in the medial parts of both frontal lobes, the genu of the corpus callosum and the right temporo-parietal region. Besides left hemiparesis, grasp reflex, and instinctive grasp reaction, CMT of the right hand was observed. No apraxias were seen. This case showed two remarkable characteristics which had not been reported before : (1) In spite of recognizing an object, the patient did not manipulate it compulsively when his eyes were closed, (2) He stopped manipulating it cnmpulsively when his eyes were averted from it. These facts suggest that in this case visual recognition of an obiect was indispensable for the manifestation of CMT. Moreover the CMT in this case disappeared in accordance with the USN. This phenomenon may be interpreted as a result of hyperattention to the right visual field due to USN.
