脳の閉塞性血栓性血管炎—ビユルゲル氏病—によると思われる片麻痺の1例

A case of hemiplegia suspected of the cerebral thromboangiitis obliterans

I．緒言

　所謂「脳卒中」並に「その後遺症としての片麻痺」は，老入に於いて，最も屡々見られる疾患の一つであり，その臨床及び病理解剖所見に関する研究も既に夥しい。

　然し乍ら，この血管性病変に依る「脳卒中発作」或は「片麻痺症状」を20代，30代の若年者，或は壮年者に見る事が必ずしも稀ではなく，かゝる症例における脳血管障害の本態に関して近年漸く深い関心が示されて来た。

This is to report a case of 21 years old single woman with right hemiplegia, which was characteristic in showing the rather ty-pical symptoms of cortical lesions affecting a young woman.

The attack occurred in this case abruptly without any known cause.

One morning, when the patient arose, she noticed the paresthesia and paralysis of the right wrist and fingers. Within that day the hypesthesia and paralysis was noticed in the right half of the face too.

On the following morning, she arose with coarse twitching of the right hand and right eye-lids, but she never lost her consciousness.

During that day these twitchings occurred about ten times, and after each attack, the hypesthesia and paralysis advanced to the proximal part of the right arm and right lower extremity. With these complaints she was admitted to our clinic on that evening

At the time of admission, the right arm, the right lower extremity and the right half of the face were paralysed. This paralysis was accompanied by light hypesthesia of these areas, where the disturbance of "two point discrimination" was marked.

The deep tendon reflexes were absent on the right side; no pyramidal sign was elicited.