レイテ島（フィリピン)における脳日本住血吸虫症の臨床的研究—日虫化学療法2年後の観察

CLINICAL STUDY OF CEREBRAL SCHISTOSOMIASIS JAPONICA IN LEYTE (PHILIPPINES) : FOLLOW UP STUDY 2 YEARS AFTER TREATMENT WITH AUTISCHISTOSOMAL AGENTS

I．はじめに

　著者らは日本住血吸虫症（日虫）の濃厚淫浸地のフィリピンの脳日虫症の実態調査を1975年2月に，主として臨床症状および脳波検査を中心に行なつた。その結果の一部は既報のとおりである^1）。今回は前回の調査対象者の約2年後の状態を調べ，同時に対象者の一部に指示した日虫化学療法が臨床症状や脳波所見におよぼす影響を検討したので，それらの結果を報告する。

During February, 1975, we lnvestigated thechnical symptoms and electroencephalographicfindings of cerebral schistosomiasis japonica inLeyte island, Philippines (Hayashi et al., 1977).Subjects were the inhabitants of the Palo districtof Leyte, and 75 suspected of having cerebralschistosomiasis japonica were selected from the listof patients, which had been prepared by Schisto-somiasis Control and Research Project. 71 casesor 95% showed paroxysmal symptoms such asJacksonian, psychomotor, grand mal and autonomicseizure. The EEG results of the subjects werenormal in 24(32%), borderline in 13(17%), andabnormal in 38(51%). In the present study, twoyears later, the same subjects were examined foran activated EEG which was not recorded in ourprevious lnvestigation, in order to determine theeffects of an antischistosomal agent.

Out of 71 cases Qf paroxysmal group,12 patientsmoved to somewhere, and 3 died, leaving a totalof 56.

As for paroxysmal symptoms,12 cases showedgrand mal,29 showed Jacksonian, 14 showedpsychomotor and one showed a mixed type ofJacksonian and sypchomotor. Symptomatically, 9patients showed these paroxysmal symptoms as-sociated with hemiparesis or motor aphasia.

As for the incidence of seizure,59%of patientshad the frequent seizures of more than once amonth. This percentage is less than the previousone,72%.

In EEGic findings,27 patients (48%) were normal,8(14%) were borderline, and 21(38%) were ab-normal. Compared with the prevlous results of68%,the ratio of abnormal to borderline, wasremarkably improved.

In the comparison of EEG,20 patients wereimproved,28 were unchanged, and 8 became worse.In the improved EEG pattern changed from ab-normal to normal, regularity of the basic rhythmimproved, the main frequency of basic rhythmbecame faster one and slow waves or asymmetrical findings disappeared. In the aggrevated EEG pattern, the main frequency of basic rhythm of some cases became slower one and more irregular,and 4 patients newly appeared seizure discharge.

As for the incidence of attack, of the 20 cases comprising the EEGcally improved group, 10 cases (50%) showed disappearance of attacks, 8 cases showed a decrease of more than 50% in the incidence of seizure, and 2 cases showed no changes. From these findings, some relationships between the EEGcally improved group and the group in which attacks have disappeared or the patient has improved are discussed.

We also examined the change of the nature ofattacks in the patients who had received anti-schistosomal agents after the previous investigation. Twenty eight patients had received Fuadin injection, 2 had received Niridazol and one had received mixed with Fuadin injection and Niridazol. Of these 31 patients, attacks disappeared in 15 and improved in 4 cases. No change was seen in 12 patients.