シンナー中毒と眼—その臨床と実験

Optic-cerebro-cerebellar-peripheral neuropathy in glue sniffers

　シンナー中毒患者の眼症状について検討を加えた．症例は視覚系に異常を認めた5例と更に病理解剖例1例と精神症状により県立せりがや園を受診した14例の合計20例である．更に動物実験として，ラットに亜急性の実験，ビーグル犬に対して慢性実験を行い人の所見と比較した．その結果はほとんど同一であり，基本はシンナー中に含まれるトルエンによる中毒であることが明らかにされた．その所見は基本的に，眼，大脳，小脳，末梢神経に認められる，optic-cerebral-cerebellar-peripheral neuropathyとしてまとめられ，1日約5時間の吸入で11.3gを4年以上吸入すると眼症のみでなく上述の症候群が発症する可能性があることを述べた．

Chronic neuro-ophthalmological toxic manifes-tations in 20 glue sniffers are described. In the pre-sent series, 5 cases manifested ocular involvements, 14 cases neurological symptoms and 1 case histopa-thologically confirmed involvements. The cases were either seen at our institution or at a psychiatric center, Serigayaen.

The whole clinical picture could be summarized as optic-cerebral-cerbellar-peripheral neuropathy. This view could be confirmed by histopathological studies and by animal experiments by subacute sniffing of toluene in rats and chronic sniffing in Beagle dogs.

Inhalation of Toluene seemed to be mainly re-sponsible for ocular toxicity, while other organic solvents, such as n-hexane, did not seem to induce severe optic neuropathies. The retina was also af-fected. There were significant changes in eye move-ments as well as pupillary dilatation. Cerebellar lesions, particularly those affecting Purkinje cells as confirmed by histopathology, were compatible with the above clinical involvements.

Ocular lesions, including optic ncuropathy in particular, were liable to occur after sniffing 11.3 grams for 5 hours a day over a duration of 4 years.