A case of bilateral paralysis of facial and auditory nerves, with left hemiplegia, in the secondary stage of syphilis / by James Carslaw, M.A., M.B., C.M., Assistant to the Professor of Medicine and Clinical Medicine, Glasgow University.

  • Carslaw, James.
Date:
[1897?]
Catalogue details

Licence: Public Domain Mark

Credit: A case of bilateral paralysis of facial and auditory nerves, with left hemiplegia, in the secondary stage of syphilis / by James Carslaw, M.A., M.B., C.M., Assistant to the Professor of Medicine and Clinical Medicine, Glasgow University. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    infrequent for patients to suffer from affections of the cerebro- spinal system in the comparatively early stages of syphilis. At this time various functional disturbances are not uncommon, such as different forms of neuralgia, and sensory disturbances, especially analgesia, to which attention has been specially drawn by Fournier. There are also abundant clinical records of par- alysis both central and peripheral occurring early. The tendency has been to regard these as early or precocious tertiary phenomena, but they probably belong as definitely to the secondary period as the skin eruptions or the affections of the throat, eyes, etc., and may be due to lesions similar to those demonstrated in the present case. Dr. Buzzard, in his Clinical Aspects of Syphilitic Nervous Affections,1 discusses the question, quoting the experience of Lancereaux and other continental authorities. Two years ago (Feb. 26 and March 12, 1895), in the London Royal Medical and Chirurgical Society, an in- teresting discussion took place on this subject: “ The affections of the nervous system occurring in the early stages of syphilis,”2 in which many of the leading British neurologists took part. The general outcome of that discussion was the recognition of the fact that nervous complications of syphilis do occur in the truly secondary stage, and that these are probably dependent on changes in the smaller bloodvessels, not in the nervous elements themselves. Such early affections are as a rule not of serious prognosis, though on account of the destructive processes re- covery may be only partial, and opportunity seldom occurs to make pathological examination. Some such examinations have however been reported with apparent absence of anatomical lesions,3 but at the above discussion Mr. Jonathan Hutchinson related a fatal case of early syphilitic paraplegia, published by M. Lamy, of Paris,4 in which microscopic changes were found in the spinal cord quite analogous to the changes found in the facial and auditory nerves, and the corpus striatum of the present case. “ The stress of the disease had fallen on the perivascular spaces of the vessels, especially the veins, and had respected 1 Buzzard, Clinical Aspects of Syphilitic Nervous Affections, pp. 43 et seq. 'See British Medical Journal,, 1895, I., p. 476, etc. 1 Heubner in Von Ziemssen’s Cyclopaedia, Vol. xn., pp. 316, 344, 354. 4 B. M. J,, 1S95, i., p. 485.