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Brain and Nerve No to Shinkei Volume 26, Issue 8 （August 1974）

Brain and Nerve 脳と神経 26巻8号（1974年8月発行）

Japanese English

原著

視床部腫瘍における体性感覚誘発反応（Somatosensory Evoked Responses, SER） THE SOMATOSENSORY EVOKED RESPONSES OF THALAMIC TUMOR 呉屋朝和 ¹ , 福村昭信 ¹ , 吉田護 ¹ , 松角康彦 ¹ Tomokazu Goya ¹ , Akinobu Fukumura ¹ , Mamoru Yoshida ¹ , Yasuhiko Matsukado ¹ ¹熊本大学医学部脳神経外科 ¹Department of Neurosurgery, Kumamoto University, School of Medicine pp.789-794

発行日 1974年8月1日 Published Date 1974/8/1

DOI https://doi.org/10.11477/mf.1406203582

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Abstract 文献概要
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はじめに

　視床は体性感覚系においてJasper以来の特殊視床投射系，汎性視床投射系の中継核といわれ，前者は内側毛帯系を経て特殊核で中継され，中心後回に達するものであり，後者は連合核を介して広く大脳皮質に投射する経路であるとされている^1）。この汎性視床投射系と上行性網様体賦活系が協調して皮質活動を促進し，意識水準を維持する役割をはたすという考えが通説となっている。ここにみられる統合的機能の存在が背景となって特殊視床投射系を上行し皮質感覚領に至るインパルスにより，われわれは種々の感覚を認識することが可能となる^2,3）。

　このように視床は特殊，非特殊投射系の中継核をなす場所であり，その障害は種々の複雑な臨床症状を呈する。この論文は両投射系に及ぼす障害が視床病変の程度により，体性感覚誘発反応Somatosensory Evoked Re—sponses （以下SERと略す），の面からも異なったパターンを呈するのではないかと推定しその検索を目的とした。われわれは最近5例の視床部腫瘍について，経過を追ってSERを記録する機会があり，興味ある所見が得られたので報告し若干の考察を述べる。

Somatosensory Evoked Responses (SER) to electri-cal stimulation of the contralateral median nerve were studied in five patients with thalamic tumor. Each patient underwent thorough neurological ex-amination, including serial angiography and air study.

Before the recording of SER surgical intervention for reducing increased intracranial pressure was made, if indicated, and recording was repeated dur-ing hospitalizations.

According to precise evaluation of symptoms and findings, the location of the tumor was analized and predominant involvement of thalamic nuclei was determined, which was later confirmed by autopsy.

The purpose of present paper was concerned mainly to the physiological significance of recorded pattern by the thalamic tumor and relation between suppressed late components (longer than 80-100 msec in latency) and involvement of non-specific group of the thalamic nuclei.

The results obtained were as follows :

1) Lesion in the specific thalamic nuclei and diffuse thalamic disturbance presented the similar pattern of SER. That was the early components and late components were both suppressed.

2) Late components were more suppressed on the disturbance of the non-specific thalamic nuclei.

3) Concerning physiological meaning of the late components of SER, the possibility was brought up that it was formed not only by the impulses from specific projection system but also diffuse projecting impulses ascending from the non-specific thalamic nuclei to the cortex and passing through the specific thalamic nuclei took part in denoting the late com-ponents.