内容紹介
Summary
Frequently, patients with advanced cancer are suffered by various symptoms at the end of life. Furthermore, sometime experience unexpected loss of consciousness(LOC)and/or respiratory arrest. I examined carefully following neck stiffness, LOC, masked face, urinary retention, tonic and/or clonic convulsions, apnea, dysphagia, head rotation, neurogenic pain, hyperthermia, mydriasis 145 patients with advanced cancer. By assuming meningeal carcinomatosis, multifocal neurological findings are logically expected. As a result, before the LOC or respiratory arrest, I was able to logically explain to almost all families of patients, who with suspected neurological signs, expected multifocal neurological signs including LOC or respiratory arrest.
要旨
死亡10日以内の臨終期がん患者では疼痛などの様々な症状が出現する他,予期せぬ意識障害や呼吸停止を経験することがある。在宅療養中の臨終期がん患者で家族や看護師でも見つけることができる項部硬直,意識消失,無表情,尿閉,痙攣,無呼吸発作,嚥下障害,頭部回旋,神経障害性疼痛,過高熱,瞳孔散大に留意して診察した。いずれかの神経兆候が出現したほぼ全員の患者家族に意識消失や呼吸停止となる前に多焦点性の神経兆候が出現し,呼吸が停止していく病態を論理的に説明することができたので報告する。
目次
Frequently, patients with advanced cancer are suffered by various symptoms at the end of life. Furthermore, sometime experience unexpected loss of consciousness(LOC)and/or respiratory arrest. I examined carefully following neck stiffness, LOC, masked face, urinary retention, tonic and/or clonic convulsions, apnea, dysphagia, head rotation, neurogenic pain, hyperthermia, mydriasis 145 patients with advanced cancer. By assuming meningeal carcinomatosis, multifocal neurological findings are logically expected. As a result, before the LOC or respiratory arrest, I was able to logically explain to almost all families of patients, who with suspected neurological signs, expected multifocal neurological signs including LOC or respiratory arrest.
要旨
死亡10日以内の臨終期がん患者では疼痛などの様々な症状が出現する他,予期せぬ意識障害や呼吸停止を経験することがある。在宅療養中の臨終期がん患者で家族や看護師でも見つけることができる項部硬直,意識消失,無表情,尿閉,痙攣,無呼吸発作,嚥下障害,頭部回旋,神経障害性疼痛,過高熱,瞳孔散大に留意して診察した。いずれかの神経兆候が出現したほぼ全員の患者家族に意識消失や呼吸停止となる前に多焦点性の神経兆候が出現し,呼吸が停止していく病態を論理的に説明することができたので報告する。