Abstract
In recent 10 years many cases of subacute myelo-optico-neuropathy following abdominal symptoms (so-called SMON) in Japan were found and discussed as a topical problem.
We experienced a case of SMON which is described and discussed about causative factors, pathological findings and etc.
This was a 42-years-old female patient, who had been suffering from psoriasis which had been treated with adrenal cortical hormon for 15 years.
She complained of abdominal aching, diarrhea or constipation since May, 1967, ar. d 6 months later she developed numbness of both lower extremities and difficulty of walking which had been persisted for 2 years. She died of fever and delirious state with sudden onset.
Autopsy findings:
In spinal cord there were pseudosystemic, symmetrical, non-inflammatory and demyelinating changes confined mainly to the dorsal column of cervical and upper thoracic cord (specifically involved funiculus gracilis) and there were slight changes in lateral column of lower thoracic and lumbal cord.
In midbrain and spinal cord there were accumulation of corpora amylacea, accumulation of lipofuscin granules of nerve cells, and Marinesco's bodies abnormally increased from her age.
In cerebral cortex atrophy of nerve cells with gliosis were noted slightly.
This case is considered as an atypical case of SMON, because of luck of visual disturbance and non-pathological change of optic chiasm.
As the causative factors of SMON, metabolic disturbances, viral infections (Coxachie A, Echo 21 or slow viral infections etc.) and intoxications (particulary Chinoform intoxication) are considered and discussed, but no definite relationship is found at present.
