慢性アルコール中毒における小脳変性—とくに限局性小脳皮質変性症の1例をめぐって

CEREBELLAR DEGENERATION IN CHRONIC ALCOHOLISM:WITH SPECIAL REFERENCE TO AN AUTOPSIED CASE SHOWING THE RESTRICTED FORM OF CEREBELLAR CORTICAL DEGENERATION (VICTOR)

　抄録　慢性アルコール中毒8例の脳髄を，小脳に重点をおいて検索した。1）症例1（52歳，男）の小脳病変は虫部前葉に顕著で，Victorらの小脳皮質の限局性変性（a restricted form of cerebellar corticaldegeneration）に一致した。このような症例報告は，わが国では非常に稀である。この例の脳髄には，そのほかに旧いWernicke　脳症の病変がみとめられた。2）他の7例の慢性アルコール中毒者の小脳では，病変は軽度であった。軽いPurkinje細胞の脱落があったが，その局在はまちまちで，虫部前葉に強調される傾向はなかった。3）慢性アルコール中毒者の小脳皮質変性症の病因について，エチルアルコール中毒およびサイアミン欠乏などに関連して，二，三の考察を行った。

The brains of 8 patients with chronic alcoholism were neuropathologically examined.

1) The findings obtained in the cerebellum of case 1 (male, aged 52) were in agreement with the restricted form of cerebellar cortical degene-ration which was described by Victor et al (1958). The clinicopathological report on the cerebellar degeneration of this type was very rare in Japan.The cerebellar changes were more pronounced in the anterior vermis than in the posterior vermis and hemisphere. Furthermore, some old lesions of Wernicke's encephalopathy were found in this brain.

2) 7 other cases showed very mild cerebellar degeneration. Partial loss of Purkinje cells was found near the tops of cerebellar folia. But their distribution and intensity had no individual varia-tion and there was no tendency that the anterior vermis was more affected.

3) This fact suggests that the alcoholic cerebel-lar degeneration may have some other cause than the direct toxic effect of ethylalcohol or its meta-bolites. The etiology of this disease was discussed with reference to thiamine deficiency and mal-nut-rition.