振戦時における体液Calcium,Magnesium値について—アルコール離脱期を中心に

LEVELS OF CALCIUM AND MAGNESIUM IN THE BODY FLUID OF PATIENTS WITH TREMOR

I．緒言

　アルコール依存症において離脱期に低Magnesium（Mg）血症が観察され，離脱症状と密接に関連することが示唆されている^6,12）。また，脳内Calcium （Ca）も身体依存の形成と密接な関連を持つといわれている^10）。アルコール離脱症状は早期症状群と振戦せん妄とに大別される^13）が，早期症状群のうち最も多く観察されるものは振戦であり，また振戦せん妄においても全身の粗大な振戦が観察される。

　一方，近年パーキンソン症候を含む薬物による錐体外路徴候出現時にも血清Ca,Mg値の低下が観察されている^1）。

It is well known that in the withdrawal state of alcoholics, low serum magnesium levels are ob-served. On the other hand, there is a report available which suggests an intimate relationship of brain calcium to the alcohol withdrawal syn-drome. Therefore we centered our efforts on tremors, which is one of the outstanding features of the alcohol withdrawal syndrome, and we in-vestigated the relationship between tremor and body fluid calcium and magnesium.

The subjects were 9 alcoholics and 6 cases of Parkinson's syndrome. As the control, the calcium and magnesium levels of the body fluid of 7 subjects with neurosyphilis and neurosis were examined.

In the cases of delirium tremens with remarkable tremors, the magnesium values in serum and cere-brospinal fluid were 1.21mEq/l and 2.07mEq/l showing a significant lowering of values compared with the controls (1.84mEq/l, 2.39mEq/l). How-ever, regarding calcium values there were no changes in the serum and the cerebrospinal fluid (Fig. 1, 2).

The serum magnesium of alcoholics was measuredrepeatedly after alcohol withdrawal and the cor-relation to the severity of tremors was studied. It was shown that in the state (A1-III) which showed continuous and severe tremors the mean value was 1.14mEq/l, in the state (A1-II) which showed only tremors of the fingers and tongue at rest, the mean value was 1.41mEq/l and in the state (A1-I) which showed tremors only when the subject willed his movement the mean valus was 1.52mEq/l. The values of serum magnesium in each state were lower than that of the control significantly (Fig.5).

In most of Parkinson's syndrome with remarkable tremors, the serum magnesium values were lower than controls. However there was no significant difference between group values for the controls and the Parkinson's syndrome.

With above results, it is concluded that there is an intimate relationship between the severity of tremors and hypomagnesemia.