ジャクソンの運動症候論

Jackson's Theories on the Nature of Motor Symptoms

ジャクソンの臨床神経学への貢献は多岐にわたるが，本稿では，その中から一側開始痙攣（いわゆるジャクソンてんかんと痙攣の行進），テタヌス類似発作（いわゆるジャクソン小脳発作），および小脳姿勢（後の除脳硬直）の3種の運動症候に的を絞り，それぞれの症候の特徴および発症メカニズムについての彼の仮説を紹介した。また，大脳運動系と小脳運動系はお互いに「協調対立」関係にあるとする，彼の力動論にも言及した。

Abstract

Of John Hughlings Jackson's many contributions to neurological symptomatology, three motor symptoms serve as illustrations of his greatness: convulsions beginning unilaterally with the "march of spasms" (later called Jacksonian epilepsy), tetanus-like seizures (later called Jacksonian cerebellar fits), and cerebellar attitude (later absorbed into the category of "decerebrate rigidity"). The author has summarized their clinical characteristics and the underlying pathophysiological mechanisms as originally described by Jackson. His unique theory of "amicable antagonism" between the cerebrum and the cerebellum is also discussed. This dynamic concept can be considered a forerunner of theories of "rivalry" between higher brain centers.