鼻咽腔類皮癌によるGarcin症候群の1例

A CASE OF GARCIN'S SYNDROME WITH A NASOPHARYNGEAL CANCER

Ｉ．はじめに

　1927年，Garcinは特異な片側脳神経の総麻痺症候群（Le syndrome paralytique unilatérale globale des nerfscraniens）^4）について記載し，その後この症候群はGarcin症候群（Syndrome de Garcin）^8）と一般に呼ばれるようになつた。本症候群の報告は比較的少なく，わが国では松島ら^15）の報告をはじめとし，著者らの調べた範囲では21例にすぎない。本症候群は脳圧亢進症状および巣症状を示さず，かつ一側の脳神経がすべて障害された症例に対して命名されたものであるが，病変の時期とその拡がり方によつて必ずしも一側全部の脳神経が侵されなくとも，あるいはまた一側のみならず他側へ及んだものをもGarcin症候群と呼称されることをゆるされているようである。われわれもこのような意味からGarcin症候群と思われる症例を経験し，剖検する機会を得たのでその概略をのべ，あわせて文献的考察を加え，本症候群に対するわれわれの私見を述べてみたい。

A case of Garcin's syndrome-Le syndrome paraly-teique unilaterals globale des nerfs craniens-was experienced.

A patient was 58-year-old male with a nasophary-geal cancer, who showed the paresis of the I, III, IV, VI, VII, VIII, IX, X, XI and XII cranial nerves on the left side, and I, VIII, IX, X and XII on the right side.

No disturbance of sensory and motor system were observed on extremities and no signs of increased intracranial pressure.

The Plain X-rays of his skull disclosed destructionof the base. Nasopharyngeal epidermoid cancer was proved by autopsy.

At the present time, "Garcin's syndrome" is characterized by : 1) unilateral involvement of all cranial nerves, 2) absence of any signs of involve-ment of motor or sensory systems on extremities, 3) absence of any signs of increased intracranial pressure, 4) abnormal X-ray findings of the base of the skull.

In far advanced stages the lesions may also spread to the opposite side. The clinical picture is nearly maintained by neoplastic process of the base.

As point out by Pisi, it is suggested that the term "Garcin's syndrome" be replaced by 'syndrome of unilateral, multiple, extensive and progressive involvement of the cranial nerves'.

We support Pisi's comment considering our case with many references for Garcin's syndrome.

In addition, we discussed about the difference of Garcin's syndrome and multiple cranial neuropathy.