パーキンソン氏病の一剖検例

AN AUTOPSY CASE OF PARKINSON' S DISEASE

まえがき

　パーキンソン氏病はParkinson （1817）により初めて記載されたひとつの内因性疾患であり，運動減少，筋強剛，振顫，姿勢異常などを主症状とするが，また炎症，中毒，血管障害などにより同様症候群を呈する時はパーキンソン病態（Par—kinsonismus）と呼ばれる。

　パーキンソン氏病の病理変化については古来多くの報告があり，殊にF．　H．　Lewy （1923〜1926），C．　u．　O．　Vogt （1920）らは線状体または淡蒼球の病変を重視したが，その後Goldstein （1922），　Hassler （1937），　Klaue （1940）らにより黒質が注目せられ，本病の主要変化が黒質にあることは今日一般に信じられるにいたつた^1）2）。

A 56 year-old male suffered from difficulty of gait, which appeared since 3 years. Phy-sical signs: Parkinsonian mask, rigidity of upper and lower limbs, tremor of legs and later of arms, slowness of movement, propulsion.

Electromyogram showed 1) grouping volta-ge of 6-8 c/s at rest, 2) remarkable dischar-ges at passive stretch, 3) non-interfered, mixed discharge-pattern at maximal voluntary contraction. 4) occasional apperance of syn-chronization voltage at voluntary contraction. Electroencephalography showed n. p. at early stage, but slow waves of 4-7 c/s at end stage.

Treatment: Artane, combining with ATP injection, was most effective. Rigidity and tremor considerably improved for about 6 months. After that, sudden attack of exacer-bation with psychical symptoms and died.

Autopsy findings: Remarkable atrophy and decolorization of substantia nigra. Histologi-cally, loss of pigments and degeneration of nerve cells in substantia nigra, most remark-able in the middle group. Besides, middle-grade degeneration and decrease of nerve cells in nucleus caudatus, putamen, globus pallidus and thalamus, slight degeneration in cerebral cortex, corpus Luysi and nucleus ruber. As peculiarity of this case, we found degeneration and fat deposition in anterior horn cells of spinal cord.