Fifty-five cases of subacute myeloneuropathy that followed a prodromal abdominal disorder have been seen during the past three years. There were two small local epidemics and one familial occurrence. No clinical distinction could be made between sporadic and epidemic cases. The neurologic manifestations, the onset of which was closely related to a preceding gastrointestinal disorder, resembled somewhat combined system disease and were chracterized by ascending paresthesiae of the lower extremities followed by spastic paraplegia or paraparesis. The upper level of the sensory disturbances was lower thoracic segments in most cases with frequent involvement of deep sensibility. Visual disturbances occurred in three cases. The abdominal symptoms included diarrhea in most cases, pain and constipation in a few. Absorption and serum levels of vitamin Bit were found to be normal. Clinically, these cases seem to represent a new disease entity somewhat similar to parainfectious encephalomyeloneuropathies. A review of the Japanese literature on this disease has been made with discussion of the etiologic possibilities.
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