前頭前野および辺縁系，特に側頭葉底部内側に高度な変性を認めたcorticobasal degenerationの1剖検例

An Autopsy Case of Corticobasal Degeneration with Predominant Involvement of the Prefrontal Lobe, Limbic System, and Especially of the Medial Temporal Base

　症例は死亡時71歳の男性。69歳時に高度の転倒傾向を伴うパーキンソン症候群と痴呆で発症，無言無動状態となって死亡。全経過2年8カ月。神経病理学的検索にて，両側前頭葉の対称性萎縮，前頭前野および辺縁系，特に側頭葉底部内側に神経細胞脱落と多数のballooned neuronを認めた。Gallyas銀染色ではこれらの部位にastrocytic plaque-like structure, argyrophilic thread, coiled bodyを認め，corticobasal degenerationと診断した。一方，中心溝周辺の前頭頭頂葉は保たれ，嗜銀性構造物もわずかに認めたのみであった。さらに軽度のAlzheimer病も合併していた。本例ではcorticobasal degenerationによる変性が側頭葉底部内側に高度であり，同疾患として非典型的な病変分布を呈していた。

We report a case of corticobasal degeneration (CBD) with prominent degenerative changes in the temporal base. The patient developed parkinsonism with a marked tendency to fall and dementia at the age of 69. His symptoms progressively worsened. Finally, he was akinetic and mute and died by infec-tion at 71 years of age, 32-months after the onset of his neurological symptoms. At autopsy, symmetri-cal atrophy of the prefrontal lobe was seen, yet the regions around the central sulci were preserved.