2011 Volume 13 Issue 2 Pages 189-197
We report a case with defective route finding who showed the improvement by the use of photo navigation map with heading arrows. The patient was a 81-year-old right-handed woman who lived alone. On October 20XX, she consulted department of neurology in our hospital because of the loss on a way to the bakery which was about 1 km away from her home since August 20XX. Physical, and neurological examination showed no abnormality. Although a brain MRI showed slight brain atrophy, 123 I-IMPSP ECT did not suggest significant hypoperfusion. In the neuropsychological assessment, MMSE score is 26/30. HDS-R score is 26/30. Unilateral spatial neglect and the prosopagnosia were not observed. A slight constructive disability was detected in Necker’s cube drawing. The test of topographical disorientation revealed not only defective route finding but also slight landmark agnosia. The only problem in her daily life was the round finding between home and the bakery and she could understand neighbor landmarks. We supposed that her topographical disorientation was mainly caused by defective route finding. We examined the patient’s topographical disorientation and how to rehabilitate by using a classification of Lynch. We prepared two pieces of maps with navigating photos and heading arrows ; one piece of map showed from home to the bakery, and another showed from bakery to her home. After the several trials using these maps, she could arrive at the bakery without them. We may say that photo navigation map with heading arrows is useful to the patient with defective route finding.
