手指外傷を既往に持つパーキンソン病の5例

FIVE CASES OF PARKINSON DISEASE WITH THE PAST HISTORY OF HAND INJURY

　抄録　手指切断などの手指の外傷を既往に持つパーキンソン病の5例を報告する。男性2例，女性3例，発症年齢40歳から74歳。第1例は左手III指切断4年後，右I指切断2ヵ月後に右手から，第2例は右II指切断19年後に右手から，第3例は右I指切傷36年後に右手から，第4例は右II III IV V指切断10年後に右手から，第V例は右III指切断33年後に右手からそれぞれパーキンソン病が発症した。パーキンソン病では神経症状発現時の強いlateralityが問題の一つであるが，自験5症例はいずれも外傷と同側から神経症状が発症しており，さらに同様の外国の報告と併せて，こうした臨床的事実はこの問題に対して一つの示唆を与えるものと考えられる。考察にLindvallらの証明した間脳脊髄ドーパミン系に若干言及する。

Incidental occurrence of Parkinson disease follow-ing to the history of peripheral trauma was reported in 1932 by Naville and Morsier. So far as we know not more than 50 cases with such an interesting outbreakes have been reported. In Japan no report has been published.

We happened to have opportunities to observe five cases of Parkinson disease with similar past history of peripheral trauma comprising two males and three females. Their age at onset ranged from 40 to 74 years and all the five cases had histories of finger injury, including amputation in four cases, followed by insidious onset of tremulous movement at the same site of the trauma during the period between two months and 36 years. So far as we know, no evident explanation is made concerning to the etiological interrelation between onset of Parkinson disease and trauma of the fingers.

It appears to be suggestive of the possible mechanism, in which chronic persistent facilitation from the site of trauma up to the diencephalo-spinal dopamine system, recently advocated by Lindvall and others, result in Parkinson disease beginning at the homolateral site of the previous peripheral trauma.