Postencephalitic respiratory disorders : review of syndromy, case reports, physiopathology, psychopathology and therapy / by Smith Ely Jelliffe.

  • Jelliffe, Smith Ely, 1866-1945.
Date:
1927
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Licence: In copyright

Credit: Postencephalitic respiratory disorders : review of syndromy, case reports, physiopathology, psychopathology and therapy / by Smith Ely Jelliffe. Source: Wellcome Collection.

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    of all of the general and accessory muscles concerned in inspiration and expiration. At the beginning of this apneic period, she spreads her feet apart and bends forward grasping her legs behind the knees and remains in this position for a few minutes making forced expirations. (Photo.). The respirations have been up to 55 or 60 a minute. This is followed by a phase in which she straightens out, brings her right hand to her neck, throws her head back and makes a violent effort at inspiration, the face being congested, cyanotic, and hemorrhagic, the eyes immobile, the veins in the neck turgid and injection of the con¬ junctiva and even epistaxis may result. In the tachypneic phase the cardiac action is rapid; the heart stops in the apneic phase. The author discusses at length the pseudoproblem of the psycho vs. somatic pathology, allying the situation with Gilles de la Tourette’s disease (also see de Saussure’s handling of the same situation), and then takes up the problems of localization of this vagohypertonic syn- dromy following Laignel-Lavastine for the terminology and Eppinger & Hess for the general conception. Case 2. A girl of eleven years came to the clinic while the report of the first case was in print and is added. The history resembles very closely that of the first patient and does not need repeating (pneumo¬ graphic tracing and pictures). Bilancioni and Fumarola6 have made a very complete study of 10 cases with excellent pneumographic tracings almost the only study save those of Mile. Levy devoted exclusively to the respiratory anomalies. Having as senior collaborator an otolaryngologist, Bilancioni, the empha¬ sis was laid upon the changes in the respiratory tract. The vocal cord movements are minutely gone into. In general they are described as resulting in a certain torpor of abduction and adduction (rigidity, J.) of the vocal cords, and are referred to mesencephalic implications. Lasagna has studied them exhaustively, also Favine—especially in the acute stages of encephalitis. The present study is chiefly restricted to the postencephalitic phe¬ nomena as affecting the larynx and respiratory apparatus. As with the type of paresis of the labioglossolaryngeal apparatus so also the respira¬ tory phenomena shows a paroxysmal arhythmia. Epidemic hiccough is one of the most interesting of the phenomena under consideration. This is related to a rhythmic clonus of the diaphragm. Mendicini is quoted as one of the investigators of the respiratory anomalies, especially studied during sleep. Case 1. A barber thirty-two years of age, January, 1920, encephalitis, oscillating fever for a month. A year later, especially at night, he 6 Bilancioni, G., et Fumarola, G. Su alcune rare manifestazioni, a forma bulbare (laringee e respiratorie), della “encephalitis chronica epidemica.” Ann. di. Med. Navale, 29, 1922, Vol. IT, 1, July, August.