著者

錦織 壮

出版者

関西医科大学医学会

雑誌

関西医科大学雑誌 (ISSN:00228400)

巻号頁・発行日

vol.30, no.1, pp.97-128, 1978

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The present author has studied from various viewpoint 14 patients who had epileptiform convulsive disorders under choronic Meprobamate intoxication and 47 additional cases which were already reported in Japanese and other languages.<BR>1) There were no specific convulsive predi sposition and family history in the author's cases. Remarkable personality disorder of these cases were often seen in the peoples who addicted any drugs and others. They had no intellectual defect.<BR>2) Generally, convulsive seizure broke out when one took Meprobamate more than 3g daily over one to several years.<BR>3) In the literature, ev ery other author understood that these convulsive seizures had occured only as abstinence syndrom. It is certain that the majorities of these convulsions occur as abstinence syndrom but others occur during the intake of this drug. Delirium or disturbance of alertness also would develop likeweise. The present author differentiated four types regardig to the occurrence of convulsive seizure as well as the intake of this drug. A: Convulsion precipitated by abrupt withdrawal. B: Convulsion which occured during intake of this drug. C: Convulsion which occured under marked consciousness disturbance. D: Convulsion which occured particularly during the treatment of marked consiousness disturbance. Clinical types mentioned above were not always same in one patient.<BR>4) A lmost all the convulsive seizures appeared to be of epileptic nature but they often came out in the form of status epilepticus.<BR>5) Neurological signs and s ymptoms such as fever, nausea, vomiting, shaking and ataxia would frequently accompanied convulsions.<BR>6) Before and after convulsion, the r e was stormy consciousness disturbance which was certainly different from initial and postical twilight state. Convulsive seizures associated with fever and neurological symptoms and severe consciousness disturbance tend to have the form of status epilepticus. Therefore these signs and symtoms suggest some serious oragnic brain damage. In this regard, the present author discovered in the literatures three cases, of whom two died during status epilepticus and the other got into comatose with fever from delirium.<BR>7) EEG finding s showed convulsive readiness under Meprobamate abuse, so it is quite natural that the convulsive seizure appears even under its abuse. Moreover, some focal signs in EEG suggest localized damage.<BR>8) It was not effective to gi ve Meprobamate for the treatment of abstinence syndrome. When, once convulsion and related disorder happened to occur, such disorders would reoccur short after re-use of Meprobamate. However, if a patient does not fall in abuse again, another convulsive disorder does not occur and clinical outcome is very favourable, so that it is not necessary to prolong anticonvulsant medication. These convulsive disorders do not look over as accidental outbursts in the patient with convulsive predisposition or as rebound phenomena after long abuse of Meprobamate that has mild anticonvulsant action.

著者

錦織 壮

出版者

一般社団法人 日本心身医学会

雑誌

心身医学 (ISSN:03850307)

巻号頁・発行日

vol.17, no.4, pp.219-227, 1977

被引用文献数

2

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Self-rating Depression Scale (SDS), which had been designed by Zung in 1965,was first translated into Japanese and fully studied by Fukuda in 1973. After statistical examination of the results, Fukuda concluded that SDS would be also useful for Japanese people.The author, translated SDS into Japanese by himself and has applied it, since 1970 at Toyosato Hospital to 54 out- and in-patients who were in neurotic and/or depressive state. As the result, it was found that the mean values of raw depressive score were almost identical to Fukuda's results in normal control subjects as well as in the patients mentioned above. Statistically no significant difference was found in the results between the author and Fukuda as far as the raw scores were concerned.The raw scores in the normal control group were significantly lower in both the author's and Fukuda's results as compared with those of Zung. A possible explanation of hte difference found in these normal subjects between U.S.A. and Japan, was made by the author exclusively from the transcultural viewpoint. He pointed out that the questions # 17 and # 20 in this scale were not adequate to the Japanese in detecting depressino and that these seemed to be a great difference between Japanese and Ameriacn with regard to their response to the wording such as "enjoy sex" and "suicide" due to their different backgrounds. Furth-ermore, after having madeseveral examinations of his results, the author considered that it was necessary to have a kind of reliability score in SDS such as was generally included in personality inventory.Thus the author concluded that, on the contrary to Fukuda's opinion, the current SDS seemed to be of little use for the Japanese and that a new Self-Rating Depressino Scale should be originated which was more fitting for the Japanese.