抄録
A review of 487 cases of MLF syndrome in the literature revealed that the incidence of causes were as follows in descending order: multiple sclerosis: 48.5%, cerebrovascular disease: 32.2%, brain tumor: 5.5%, trauma: 3.9%, encephalitis: 2.7%, Wernicke's encephalopathy: 1.6%, systemic lupus erythematosus and lupus erythematosus diffusa: 0.8%, atrophy: 0.6%, Arnold-Chiari malformation: 0.4%, myasthenia gravis: 0.4%, syphilis: 0.4%, and unknown: 2.9%.
One of the authors' two cases was a 37 year-old female who was hit by a moving car from behind and lost consciousness for 5 hours, remaining drowsy thereafter. On the following day, she became alert and found it difficult to walk because of severe dizziness. She subsequently visited the out-patient clinic and showed classic findings of the MLF syndrome. This patient was observed for the following 6 months until all signs had disappeared.
Another case was a 49 year-old female who was hit by a car and lost consciousness for a while. She sustained right facial paralysis of the peripheral type. Three months after the accident, she was recommended to undergo hypoglossofacial anastomosis and was admitted to the hospital. On admission, she was found to have signs of the MLF syndrome. This patient was observed in the out-patient clinic but has not shown any evidence of recovery.
Localization of the responsible site for this syndrome has been achieved in animal experiments. The authors postulated that the lesion in these cases might be in the dorsolateral quadrant of the upper brain stem. This region is very close to that found in the autopsied cases of fatal non-missile head injury described by Adams.
