Double optic neuritis with paralyis of olfactory nerves, and sensory division of right fifth nerve / by John B. Story.

  • Story, John B.
Date:
1884
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Licence: Public Domain Mark

Credit: Double optic neuritis with paralyis of olfactory nerves, and sensory division of right fifth nerve / by John B. Story. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    ness came on very rapidly, if not quite suddenly, and persisted until the end of July, 1883, when she gradually recovered conscious- ness, and became alive to the alarming fact that her senses of sight, taste, and smell were lost, and that the sensation of touch on the right side of her face, and on the little finger and the ulnar side of the ring finger of her right hand, had also disappeared. Until she became unconscious she states that she suffered from nothing but the pain in her head, all her various organs of sense being in perfect order, but she acknowledges on questioning to a derangement of her stomach and attacks of vomiting during the period preceding the unconsciousness. Her condition at present is as follows:— She suffers no pain, and beyond the defects of sense described above, has nothing to complain of in her physical condition. The sense of smell is completely absent in both nostrils, the odours of assafcetida, valerian, and iodoform being entirely unappreciated by the patient. Ammonia produces a slight and indefinite sensation, probably from its action upon the mucous membrane of the left nostril, whose tactile sensibility is unaffected. Both optic nerves are atrophied, and the preception of light entirely lost in each eye. The functions of the third and sixth, and, so far as I know, those of the fourth nerve also are unaffected, the motions of the globes in all directions being perfectly normal, and the pupils contracting simultaneously with convergence of the visual axes, although, of course, the pupillary reflex to light is entirely lost.3 The sensory division of the fifth nerve upon the right side is completely paralysed. Tactile sensibility is absent upon the right half of the head and face, from the median line to a line drawn about one inch in front of the external auditory meatus, and from the vertex to the lower edge of the inferior maxilla. There is evidence of sensibility in the skin over the angle of the jaw, in the external auditory meatus, and over all parts of the external ear; also in the skin covering the posterior portion of the temporal fossa—those portions of the skin which receive branches from the cervical nerves in addition to the filaments coming from the fifth. The corneal and conjunctival sensibility is entirely absent, as well » To-day, April 18th, my attention was called by Dr. Keane to the fact that the light reflex had returned to the right eye. Perception of light is still, however, absent.