反復する脊髄横断症状を示した肺吸虫迷入の1例

ONE CASE OF INTRARACHIDIAN PARAGONIMIASIS WITH RECURRENT SPINAL TRANSVERSE SYMPTOMS

まえがき

　一部の流行地を主として，本邦の殆ど全域に分布しているウエステルマン肺吸虫（paragonimus　westermani）の異所転移殊に脳内転移に就いては，これが痙攣発作，運動，知覚麻痺及び脳圧亢進症状を現わして，古くから脳腫瘍との鑑別上注目され，幾多の知見が報告されて来た^1）2）他。一方同じ中枢神経系内でも脊髄転移は極めて稀で，本邦では道免^3）氏（1954）の例を除いては確実な記載は見られず，外国でも，Diaconita^4）は朝鮮で本症の1例を経験し（1957），従来これに関する知見は全く見出されなかつたことを述べている。ここに我々は5年半にわたつて脊髄横断症状を5たび反復した特異な臨床像を示し，椎弓切除術によつて本寄生虫の脊椎管内迷入を確認した1例を経験したので報告する。

A very rare case of paragonimiasis with intrarachidian localisation was presented. The patient showed five attacks of spinal transverse symptoms during five years.

Both myelography and laminectomy confi-rmed grouping cysts of paragonimus weste-rmani in the level between the second and the fourth thoracic vertebrae. The ways of invasion and mechanisms of the recurrence of the symptom were discussed. Concerning the way of invasion, it seems that the larva arrived at the intervertebral foramen through the perivascular or perinervous tissue. It is conceivable that the recurrence of the symp-toms may be due to the following possibili-ties, one that the larva invaded intrarachidian space many times, or the other that the intrarachidian larva repeated its activity.