特異な経過を呈したアルコール性小脳変性症の1例

A Case of Atypical Alcoholic Cerebellar Ataxia

【抄録】　断酒後約7か月にわたって小脳失調が進行したアルコール依存症の1例を経験した。本症例ではVictorらのまとめたアルコール性小脳変性症と比較すると，上肢の失調症状，構語障害，眼球運動障害などを認めた点と，断酒後約7か月にわたって小脳症状が増悪した点が特異的であった。本症例にTRH療法を施行したところ，症状の進行が停止した。小脳症状発症前後の頭部CTでは明らかな小脳萎縮の増悪は認められなかった。

　We report the case of a patient with chronic alcoholism who presented with progressive cerebellar ataxia despite complete abstinence. Our patient was remarkably different from the cases with alcoholic cerebellar degeneration described by Victor et al. (1959), in that his cerebellar ataxia progressed for seven months after he began to abstain from alcohol. The clinical features were also characteristic in that ataxia involved his upper limbs and eye movements as well as speech. The ataxia ceased deteriorating after TRH administration. A brain CT had already demonstrated cerebellar atrophy even before the onset of ataxia, but this atrophy, revealed no significant interval change in the frequency of ataxic movements.