Pathological changes of human sural nerves in Minamato disease (methylmercury poisoning). Light and electron microscopic studies.

Biopsy of the sural nerve was performed on six patients with relatively mild Minamata disease of 10-year or longer duration. All of the six patients presented characteristic pathologic changes. Light microscopy disclosed the formation of irregularly shaped myelin sheaths and fine axons, an increase in them, which is suggestive of incomplete regeneration, cicatrization following the loss of nerve fibers, increase in Schwann's nuclei, and formation of Büngner's bands. Electron microscopy revealed incomplete myelinated fibers and ultrafine unmyelinated fibers associated with incomplete regeneration, formation of regeneration units, and collagen increase. The laminar encapsulation with the processes of Schwann's cells were often observed in ultrafine fibers. In view of the fact that small quantities of mercury-contaminated fishes are still being caught in the Minamata district, myelin degeneration, glycogen deposits and appearance of dense bodies in axons, and vesiculation and fragmentation of endoplasmic reticulum were observed as degenerative changes due to the effects of mercury accumulation.