Diffuse sclerosis (encephalitis periaxialis diffusa) / by L. Bouman ; with 64 illustrations.

  • Bouman, L. (Leendert), 1869-1936.
Date:
1934
Catalogue details

Licence: In copyright

Credit: Diffuse sclerosis (encephalitis periaxialis diffusa) / by L. Bouman ; with 64 illustrations. Source: Wellcome Collection.

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    and saliva dribbled from her mouth. A very doubtful Babinski reflex was present on the left side. No incontinence occurred. After this fit she was disoriented, drowsy, and amnesic for some hours. Her pulse became gradually normal. She remembered nothing ol the attack. Sept. 12.—The Wassermann reaction in her serum was 0-2. The Wassermann reaction in her cerebrospinal fluid was negative, but this was under high pressure. The Nonne reaction was slightly positive, but there was no pleocytosis. Sept. 17.—Increasing headache, drowsiness, and a slow irregular pulse (40 to 60) varying in frequency and in volume. The cerebro¬ spinal fluid was at a pressure of 65 cm. After lumbar puncture the pulse was quicker, though still irregular. Nonne’s reaction was still slightly positive, but the Wassermann test was negative and there was no pleocytosis. After the puncture there was, for a short time, improvement in her general condition, but owing to her poor pulse, the epileptic fit, and an increasing drowsiness, trepanation was decided upon. The congestion of the optic discs and high fluid pressure gave rise to the suspicion of a tumour or cyst. The hemianopia, subjective visual perceptions in the blind parts of the visual fields, and a suspicion of an “ uberschiissiges Gesiehtsfeld ” pointed to the disease of the occipital lobe. Sept. 20.—Operation. Neither trepanation nor puncture revealed anything abnormal in the right occipital lobe. Sept. 27.—The patient felt better, but complained of double vision. The fundi remained unchanged. Oct. 5.—Eyesight and hearing diminished rapidly. The patient vomited once or twice. Oct. 12.—General condition fairly good, but the patient complained of headache. Oct. 24.—General health satisfactory, but the patient was psychic¬ ally on the decline. She no longer recognized her physician and was scarcely able to obey any order. There was perseveration of orders once given and successfully executed. Vision was so much reduced that she could no longer fix individuals in her room, and she spoke to persons who were not present. After severe attacks ol frontal head¬ ache she had violent fits of screaming. Oct. 28.—The patient returned home. Left and right vision 1/60 at the most. There were no longer any disturbances in the fundi. More accurate examination was impossible. Feb. 8, 1923.—The patient was examined at home ; naturalh this examination could be only incomplete. The most sti iking symptoms were : paresis of both legs and of the right arm, and tendc r- ness of the right leg. The right Achilles reflex was brisker than the