痙攣発作にて発症した脳嚢虫症の1手術例

A Case of Neurocysticercosis Presenting as Focal Seizure

I．はじめに

　有鉤嚢虫症とは，人体の小腸に寄生する有鉤条虫Taenia soliumいわゆるサナダムシの幼虫が中間宿主の体内で被膜を有して嚢尾虫に発育した状態をいう．中枢神経系に多く寄生する有鉤嚢虫はソ連，東欧諸国，中南米，中央，南アフリカ，アジア（特に中国，インド，インドネシア）に多いが，本邦では非常に稀な疾患である^13,14））．今回われわれは痙攣発作で発症した脳有鉤嚢虫症を経験したので報告する．

　In Japan neurocysticercosis is a rare disease. We report a case of neurocysticercosis with a review of the literature.

　A 29-year-old man presented focal seizure on the left side. Physical and neurological findings on admission were unremarkable. CT and MRI shdwed a mass with ring-like enhancement and perifocal edema in the right frontal lobe, as well as multiple small masses with calcification. The main mass measuring 8mm in diameter, was suspected as the eliptogenic focus, and was totally removed via the transcortical approach. Postsurgically seizures did not recur, and histological examination of the mass confirmed a cysticercus. A therapeutic course of albendazole and praziquantel administered postsurgically was effective for the multiple intraparenchymal masses.