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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    Aug. 4, 1921.—The patient had epileptiform attaeks in which both the head and eyes turned towards tlie right. In addition to these fits he was subject to convulsions which involved the right half of the face and the right arm and leg, and at times spread over the whole body. During the lit the left arm was flexed in a tonic attitude close to the head ; no convulsions were observed in the left arm. The left leg was also in tonic contraction, but sometimes convulsed too. Two hours after the attacks ceased the right arm was very weak, the left spastic, and the right corner of the mouth drooped ; the right leg was weak and the left spastic. The abdominal and arm reflexes could be obtained, 'the knee-jerks were very brisk, the left rather more so than the right, and the Achilles-jerks were also brisk. Bat linski’s sign was not present. Aug. 13.—Upward and downward movements of right hand and arm occurred ; the right leg was continually flexed at the knee and hip, and the head was rigidly turned towards the right. The left arm was weak and the right spastic ; slight clonic movements of the right foot and calf muscles occurred, the foot being in the varus position. Babinski’s sign was present on the right side. The left foot was weak and spastic, but Babinski’s sign was not obtained. The knee-jerks were brisk but the Achilles-jerks were normal. The right leg was hyperalgesic. When the left leg was pricked the right was drawn up and the left moved slightly ; pricks on the left foot caused dorsal flexion of all toes. Otherwise sensibility to touch and pain were not disturbed. Pricking the paralysed left arm caused abnormal move¬ ments of the right arm. The pupils were dilated and the eyes turned towards the right. Aug. 19. Sept. 2, 9, 18.—Seizures, which ceased on the adminis¬ tration of amylene hydrate. October.—The patient scarcely spoke and there seemed to be some disturbances of speech. He frequently moved his upper and lower limbs ; the right leg was constantly kept rigidly flexed at the knee and hip. November.—A condition of progressive dementia. The patient laughed or cried on being addressed ; he answered no questions and hardly spoke, but often whined and moaned. Jcin. 2, 1922.—The patient became comatose ; after about half an hour he began to vomit and developed convulsions of the whole body. Epileptiform fits occurred at irregular intervals which could not be controlled by amylene hydrate. The temperature rose to 40 C. Jan. 3.—The left arm was in constant motion and the left corner of the mouth twitched. The left leg, which was not now paretic, was sometimes drawn up, but more commonly extended. There was no paresis of the right arm, but the right leg was very spastic and dropped