動脈瘤及びストマイによる症候性眼筋麻痺性偏頭痛の2例

Two Cases of Symptomatic Ophthalmoplegic Migraine due to an Intracranial Aneysma/and Toxic Effects of Streptomycin

　1890年，Charcotが偏頭痛の特殊型として，眼筋麻痺性偏頭痛を報告して以来，多くの報告を見るが一方，Blamwell （1934），Sjöguist （1937）柴田（1956）等は，その原因として頭蓋内動脈瘤を認め，近時それ等器質的変化に伴う症例は益々，増えつつある。吾々も最近，発病初期には眼筋麻痺性偏頭痛と診断され，その後の検索によって器質的原因をたしかめ得た2例を経験したのでここに報告する。

　症例L40歳。♀。家族歴は実母が轡慣性頭痛。既往歴特寵なし。

Two cases of symptomatic ophthalmoplegic migraine were reported.

Case 1. A 40-years-old female complained of severe left-sided migraine. The evidence of ophthalmoplegia of the left eye was mani-fested by ptosis, mydriasis and loss of direct light reflex. Cerebrospinal fluid was found to be slightly xanthochromatic. A cerebral angiogram revealed an aneurysma of internal carotid, which was as large as a red bean and seemed significant as the cause of the disease.

Case 2. A 34-years-old female with pulmona-ry tuberculosis had felt nausea and dizziness every time when she had been treated with streptomycin. She developed severe nausea, vomitting and migraine when the total dose of the drug was 35 gr. At this time both-sided ophthalmoplegia was manifested also. Cere-brospinal fluid pressure was 250 mm/Hg, though no finding of haemorrhage or inflam-matory process was obtained. Then the pat-ient lapsed into a semi-concious state. Over several weeks after discontinuing strepto-mycin all symptoms cleared gradually.