Case in which attacks of intermittent tonic muscular spasms, immediately followed by complete temporary paralysis, have frequently and periodically occurred during the entire life of the patient, the health in the intervals being normal / by A. Hughes Bennett.

  • Bennett, A. Hughes (Alexander Hughes), 1848-1901.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Case in which attacks of intermittent tonic muscular spasms, immediately followed by complete temporary paralysis, have frequently and periodically occurred during the entire life of the patient, the health in the intervals being normal / by A. Hughes Bennett. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Present condition—A. Baring the intervals of the attaclcs.— The patient is pale and delicate-looking, and seems several years younger tfian her age, but all the organs and functions are normal, the body is well nourished, and the general' health is good. She has a peculiar sardonic expression, owing to the lower lip being tightly contracted round the teeth, over which the upper lip projects. There is marked flattening of the skull in the region of the posterior fontanelle. The movements of the eyeballs are somewhat restless and unsteady, and there is difficulty in fixing them on any object, but there is no strabismus or otherwise deficient action. The pupils are equal and normal, and contract to light and accommodation. Vision is natural. The mouth and face are symmetrical, but their movements are accompanied by slight choreic-like twitchings. The tongue is straight, and its actions are apparently normal, with the exception of a slight restlessness on movement. The articulation is not very distinct, but without marked peculiarity. The patient is cheerful, and willingly assists in the work of the ward; she answers questions of an ordinary kind, and conducts herself in a way which has not caused any special comment from the nurses. Her intelligence is, however, evidently defective. She is slow and stupid, childish in her manner, cannot give an account of her illness, has a bad memory, and cannot read or write. The special senses are all intact. The appearance, movements, and strength of the limbs are normal in every respect, except that there is a constant slight restless or choreic-like movement of all the extremities. The grasp of the hands and all the actions of the upper limbs are as in health. Locomotion is normal, and the patient can walk and move about like other persons. There is no rigidity or wasting of the muscles, which have a natural appearance. Sensibility of the skin is everywhere normal. The knee-jerk phenomena are distinctly increased, but the plantar reflexes are normal. The mechanical irritability of the muscles is not markedly augmented. The electrical reactions are somewhat difficult to determine with delicacy, owing to the nervousness of the patient, and to the choreic-like movements of the limbs. They appear to bo everywhere normal, with the following modifications. 1st. Stimiilating the muscles with the galvanic current causes more vigorous contraction with the same strength of current, than wlien the trunk of the nerve which supplies them is acted upon. 2nd. In both muscles and nerves the AOC is slightly but distinctly greater than the ACC; the KCC being greater than either, and KOC is not obtainable by the strongest currents which could be tolerated.