多核神経細胞について

On the Multi-Nucleated Nerve Cells

Ⅰ．緒論

　多核神経細胞は神経病理学の古い課題である。これにはすでに今世紀の初めから多くの業績がある^1）2）。私が今また改めてこの問題を取上げるにいたつたのは二つの事情による。一つは最近私が調べた日本脳炎後遺症の4例について，その病変の主座である視床に多数の2核神経細胞を認めたことである。第二に私は現在精神薄弱の脳病理を追求中であるが，その大脳皮質はやはりよく2核神経細胞をみかける。そこてこの2つの所見は果してどこまて病理学的に意義があるものかどうか？　が出発点となつた。そしてこれを機に多核神経細胞の現われるいろいろな疾患について，松沢病院の症例を中心にして，総括的に再検討しなおしてみたいと思つた。

　その結果，従来ともすればこの問題が小脳Purkinje細胞に偏つて論じられてきたこと，および他の病変ときりはなして2核細胞のみが取上げられてきたことを反省することになつた。すなわち小脳のみならず，視床，黒質，大脳皮質などにもスペクトルを拡げることにより，多くの症例において，はつきりとした病変と密な関連性をもつて，多核神経細胞が現われることを知つた。ここに私は自然と多核神経細胞の発生については，より後天説に傾いた立場に立つこととなつた。

The pathological meaning of the multi-nuclea-ted nerve cells in the brain was discussed in connection with the concommitant pathological changes found in 20 cases of the various central nervous system diseases.

Many binucleated nerve cells were found, along with other pathological changes, in the thalamus of the chronic Japanese encephalitis cases repor-ted by Hamada et al. Multi-nucleated nerve cells were found also in and around the pathological changes in the brain of postencephalitic parkin-sonism, epilepsia, Schilder's disease, general pa-resis, and cerebral arteriosclerosis.

Thus, a common causative factor was assumed for both binucleated cells and other pathological changes. On the other hand, the binucleated cells were few in number in the brain with pachygyria and heterotopia, and those of mental deficiency without specific organic findings. Besides, a small number of the binucleated cells were also found in the brain of normal controls. Thus, the multi-nucleated cells in the brain of this group seems less meaningfull pathologically. Although manymulti-nucleated nerve cells were found in the Purkinje cells of juvenile general paresis, these were accompanied by heavy changes due to the disease process. This may reduce the importance of developmental abnormality of the brain in this condition as the causative factor for the multi-nucleated nerve cells.

Thus, the importance of acquired factors in the pathogenesis of the multi-nucleated nerve cells will be indicated.