多彩な中枢神経症状を呈した慢性トルエン中毒の1例—特にMR，SPECT, PET所見から

A Case of Chronic Toluene Intoxication with Various Central Nervous System Symptoms: special reference with MR, SPECT and PET findings

　【抄録】　多彩な中枢神経症状を呈した慢性トルエン中毒の1例を報告した。症例は22歳の男性。8年間純トルエンを乱用し，その間人格変化，知能低下，著明な痙性対麻痺，小脳失調などの症状が出現した。MRでは大脳，小脳，脳幹に及ぶ広範な萎縮のほかに，T₂強調画像で，大脳白質と橋底部に高信号域を，両側視床に低信号域を認めた。またSPECTとPETでは大脳白質や左視床領域に脳血流の低下や糖代謝の低下を認めた。これらの画像所見は本例でみられた精神神経症状の裏づけとなるものと思われた。

　This report describes a case of chronic toluene abuse with various central nervous system disorders. The patient was a 22-year old male. He had abused pure toluene for eight years and developed personality changes, mental deterioration, spastic paralysis and cerebellar ataxia. MR revealed diffuse atrophy of the whole brain. In addition to this, T₂-weighted images revealed widespread high intensity areas in the cerebral white matter and ventral pons and low intensity areas in the bilateral thalamus. Using SPECT and PET, it was shown that there was reduction of blood flow and of glucose metabolism rate in the cerebral white matter and left thalamus. We concluded that the various neurological and mental disorders in this case were related to the CNS damage disclosed by our neuroradiological study.