胃切除後に見た痙性脊髄麻痺の1例について

A CASE OF SPASTIC PARAPLEGIA FOLLOWING GASTRECTOMY

　1865年，Charcot^1）が脊髄側索硬化症に就いて報告して以来，Spastic Spinal Paralysis （Pri-mary Lateral Sclerosis）に関して，数多くの知見が発表され^{2）3）4）5）6）}，その臨床症状並びに病理学的所見は判然としてきた。然るに，その原因に関しては，猶不明な点が多い様である。

　我々は今回，胃切除後1年以内に発病した痙性脊髄麻痺の1例を経験したので報告する。

The pathogenesis of spastic spinal paralysis (primary lateral sclerosis) is still unknown. In this paper the following case was presented.

Case A house wife, 60 years old. Chief complaints were disturbance in gait, and numbness in the legs. She was apparently in good health until September 1955, when she was suffered from gastric ulcer.

Then profuse hematemesis was occurred.In June, 1956 she was operated (gastrectomy,Biliroth II method). After the operation general malnutrition was marked, and she was reduced about 8 kg in weight. Since theend of August, she has felt trembling of fingers in eating and writing. One year after the operation, she noticed cramps in the legs,and gradually the gait became difficult. No sphincter disturbances. She was admitted to,hospital on 29, November 1957.

On admission, there was no organic mental syndrome. The cranial nerves were normal.Upper extremities: No paralysis, exaggerated.deep reflexes bilaterally. Lower extremities Marked spasticity in muscular tone, exagge rated deep reflexes with Babinski's sign,ankle clonus and patellar clonus. Gait was spastic paretic. Sensations were normal.