Abstract
We examined an approach for acquiring a procedure for movement in a case of prolonged heading disorientation. The patient was a 68-year-old right handed man, presented topographical disorientation due to cerebral hemorrhage extended from the right retrosplenial region to the medial parietal lobe. Initial attempts at having the patient hold a common map and practice moving while looking at it were ineffective. This was thought to be caused partly by the fact that the patient could not judge which direction on the map corresponded to the direction he was momentarily facing at each point during his movement. Here it was very effective to use memos that linguistically described the scenery and turns that were landmarks along the route to the destination without using visual means, and the patient was also able to move without using the memos by verbally memorizing it. Heading disorientation often disappears after a short period, but this symptom is a major obstacle to movement inside hospitals and the like. Rehabilitation using written memos such as the one used in this case is effective as a way to compensate for the directional disorientation of heading disorientation, and we think that it should be promptly and actively adopted.
