進行性顔面半側萎縮症の1例—自律神経機能よりみた病因の検討

PROGRESSIVE FACIAL HEMIATROPHY, A CASE REPORT

　I．緒言

　進行性顔面半側萎縮症は比較的稀な疾患であり，その原因についてはなお不明であるが，自律神経性栄養障害に基因するとする考えが強い^2）。今回，われわれは進行性顔面半側萎縮症の1例を経験し，本症例について自律神経学的検索を行ない，その病態について若干の検討を試みたので報告する。

　A case of 39 year-old female affected with progressive facial hemiatrophy is studied by means of investigation in the autonomic nervous system.

　The following findings are observed:

　The mecholyl test showed decreased facial perspiration and no alteration of the amplitude in finger plethysmograph on the affected side; pilocarpine test showed hyposecretion of the parotid gland on the affected side. These findings assumed parasympathetic abnormality.

　On the other hand, pupillary reactions to drops of phenylephrine showed hypersensitivity on the affected side and the pupillary light reflexes on this side showed, either, prolonged redilation or two phases in the dilation course of the reflex.

　These results are suggestive of sympathetic abnormality.

　Concerning the etiology of this disease, it was supposed that it was not only caused by peripheral nervous lesions but also that of the central autonomic ones.