Facial spasm and tic, torticollis : diagnosis and treatment / by Tom A. Williams.

  • Williams, Tom A. (Tom Alfred), 1870-
Date:
1910
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Licence: In copyright

Credit: Facial spasm and tic, torticollis : diagnosis and treatment / by Tom A. Williams. 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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    Spasm. Tic. Chorea. Cerebellar and Rubro- spinal Tremor. When tonic, d i s - tinguished from stereo- typed act by absence of catatonic attitude. Muscles often en- feebled. No weakness, often hyperkinetic hyper- trophy. Myasthenia, hypo- tonia. Myasthenia, hypo- tonia, or the reverse. Exaggeration of re- flex concerned only. Reflexes normal. Reflexes often modi- fied. Reflexes increased. Distribution of peripheral nerve. Locality condition by an idea. Laterality. Laterality or not. Often painful, al- ways distressing, no craving. Painless. Sometimes painful. Never painful. Persists in and may interrupt sleep. Tic disappears in sleep. Sleep interfered with. Disappears in sleep. Purposeless. Pseudo co-ordinate, intentional act. Purposeless. Purposeless. Irreproducible v o 1 - untarily, unmodified by volition or emotion ? Influenced by emo- tion or volition, but impulsive and followed by satisfaction, al- ways arrestible (leav- ing no trace) by a sub- terfuge, a neutralizing act, inefficacious me- chanically or physio- logically, but effective psychically; also vari- ously by solitude, dis- traction, position, etc. Practically i n c o n - trollable by will, ag- gravated by emotion. Minimized at rest. Variable tetiology, but generally periph- eral irritation, e.g. trigeminal neuralgia (which is not a true tic). Psychasthenic char- acter. Similar hered- ity, but always first generated by a de- termining stimulus; it is the sequel to the un- hindered repetition of a once voluntary pur- posive act, becoming an impulsive obses- sion. Acute rheumatic dia- thesis, probably bacte- rial. No similar hered- ity. Variable neoplasm. Thus, if the motor reaction is consecutive to pathological irritation at any point on a bulbospinal reflex arc, it is a spasm. If the cortex is or has been involved in its production, it is not a spasm. Should it present, in addition to the fact of cortical participation, the aforementioned distinctive psychological features, it is a tic. Jacksonian convulsions, hemiathetosis, and the tremors preceding or following hemiplegia are all easily distinguished from both spasm and tic by accessory characters well known to every neurologist, which need not here be discussed.