肝脳疾患特殊型（猪瀬）の意識障害発作治療—GOBABの試用

TREATMENT OF THE EPISODIC DISTURBANCE OF CONSCIOUSNESS IN PORTAL SYSTEMIC ENCEPHALOPATHY BY GOBAB (γ-hydroxy-β-aminobutyric acid<DL form>)

I．はじめに

　われわれは過去6年間に肝脳疾患特殊型（猪瀬）11例を経験し，その臨床・病理^1）2）3），脳波^4）5），さらに生化学的諸知見^6）7）について報告をかさねてきた。本症に特徴的な周期的意識障害発作発生の機序はなお明らかでなく，したがつてそれに対する治療方針も確立されていないのが，現況といつても過言ではない^{8）9）10）}。

　そこでわれわれは，本症の3例に科研化学株式会社の試作薬であるGOBAB （γ—hydroxy—β—amionobutyric acid （DL form））3〜6gの内服，ないしは1〜2gの静注を，継続ないしは間歇的に1年以上に及ぶ長期間行ない，発作性意識障害の消失ないしは減少が確認されたので，その経験をここにまとめて報告する。

Three cases of this disorder (a 30- and a 40-year-old male and a 30-year-old female) having episodic disturbance of consciousness have been treated by GOBAB. It was given either orally (3-6g) or in-travenouslly (1-2g) for the total periods of 12, 18 and 16 months in the 3 cases, respectively. In the first case, the episodes have not been observed since this medication ; they have been apparently decreased in the second case and a temporal diminution of the episodes, especially at the first trial of this medica-tion, was noted in the last case.

Measuring blood ammonium, serum citrulline and visual evoked response simultaneously, the clinical effect of GOBAB was also objectively confirmed.

There were no significant side effects during this medication.