小児神経学と成人神経学に架かる橋

The Bridge between Pediatric and Adult Neurology

小児（科）と成人（科）は15〜17歳で分けられるが，臨床神経学でこの境をまたぐものがある。下記の3つのテーマについて述べた。①手の運動機能：小児での発達とそれと対照的な成人での障害を大脳連合野の観点から論じた。②肝レンズ核変性症：Wilson型（小児）と偽性硬化症型（成人）とを臨床・病理学的に分析した。③平山病：成人神経学で見出されたが，思春期を中心に小児と成人（若年）にまたがることを示し，小児神経科の重要性を指摘した。

Abstract

Pediatric and adult departments are differentiated based on a cutoff age of approximately 15-17 years. In clinical neurology, there are certain disorders and related problems that overlap these age-determined boundaries.

In this review, the following three themes are discussed.

(1) Manual dexterity: Considering motor skills through the developmental stages of a child and manual impairment due to localized brain damage in adults, manual dexterity has been reviewed extensively from the perspective of cortical association areas.

(2) Hepatolenticular degeneration: Wilson's disease (children) and Westphal-Strümpell pseudosclerosis (adults) are compared and assessed based on the age of onset to identify differences in clinical symptoms and pathological findings.

(3) Hirayama disease: This disease has been identified as an adult neurological disorder. Since the onset of Hirayama disease occurs around puberty in children and adolescents, it provides a connecting link between pediatric and adult neurology.