いわゆる外傷性神経症の臨床脳波学的研究

POST-TRAUMATIC DISTURBANCES IN CASES OF HEAD INJURY AND THE ELECTROENCEPHALOGRAPHY (CLINICAL STATISTICAL VIEW OF THE TRAUMATIC NEUROSIS)

序論

　近年労働災害や交通事故が極めて増加しつつあり，それに伴い臨床上に頭部外傷が重要な対象となつているが，本症が中枢神経である脳の損傷を何らかの程度で示す以上，たとえ受傷時に生命的危機を脱し得たとしても，その後さまざまの継発症，後遺症を残すことが多く，このことは更に一層医学的な関心事となる。

　外傷によつて生ずる脳損傷には種々の程度があるが，それに伴う外傷継発症ならびに後遺症の様相も千差万別である。頭部外傷の後遺症としては，脳神経麻痺の如く受傷時に決定される巣性脱落症状と，受傷後の経過中に現われる晩発性脳出血，慢性硬膜下血腫，外傷性てんかんなどのように局所解剖学的変化の明瞭なものがある一方，そのような局在性の明らかでない多様な自覚的苦訴を内容としたいわゆる「外傷性神経症」を含む狭義の外傷後遺症がある。そして事実，神経精神科の臨床では外傷後に神経学的所見の有無に拘わらず，神経衰弱様症状をはじめとして神経症的な病訴を頑固に長期間もちつづける患者に接するこどは極めて多く，診療上その執拗性，持続性に困惑することが稀ならない。

A head injury has a tendency to cause many kinds of neurotic symptoms which last a long time. However, in many cases it is hard to find a physical change, which is a cause of the complaint, by usual clinical examina-tion. We always guess that there is some physical ground behind the symptom which looks like neurotic apparently. And we per-formed electroencephalography on more than one hundred cases.

These results are as follows:

(1) Materials: Cases; 114 (4 are women),Age; 19-59 years old.

All of them showed neurotic symptoms at the times of the examination. And they were devided into 4 groups.

a) 70 cases showed only neurasthenic and neurotic syndrome.

b) 19 cases with apparent character change and dementia.

c) 15 cases with neurological signs or organic change.

d) 10 cases with convulsion.

(2) From 3 months to 5 years passed since the head injury.

(3) From the grade of unconciousness at the time of a traumatic attack, they were devided into 5 groups.

(4) The following were distinguished points about EEG.

a) tendency to low voltage,

b) a tendency to fast activity,

c) a tendency to irregular activity, and