A study of a case of family periodic paralysis / John K. Mitchell.

  • Mitchell, John K. (John Kearsley), 1859-1917.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: A study of a case of family periodic paralysis / John K. Mitchell. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    A younger brother has suffered in the same way, but the attacks did not begin with him until he was a grown man, and have since occurred only at long intervals. A daughter of this brother, now between twelve and thirteen years of age, has periodic palsies of the same sort, and full details of these two cases follow my patient's history. None of the other cousins except this one has ever had the family affliction. The mother of the patient began to have periodic paralyses when fourteen years of age, probably at about the time when her menstruation appeared. Their approach was sometimes announced by a slight sense of helpless- ness, which would last for a whole day. Going to bed with this, she would wake in the morning with total muscular paralysis, usually last- ing thirty-six hours, seldom longer, and never more than forty-eight. The paroxysms recurred at long and rather irregular intervals, often months apart, and after she reached adult life decreased in frequency with the advance of years, and ceased altogether at about the thirty- eighth year. She is now forty-four years of age, and presents some interesting symptoms. Mrs. E. J. is a well-looking woman, scarcely appearing as old as she is, calls herself perfectly well, menstruates regularly, and is active men- tally and physically. She has a little difficulty in walking unless the ground is perfectly smooth ; a very slight inequality makes her stumble, and if she stumbles she is very apt to fall. This is especially marked at night, when she cannot see where she is going, and has been noticed for some years. When sitting she gets up with some difficulty, rising as if her legs were weak, with a sort of wiggle, and aiding herself with the nearest object upon which she can lean. She thinks this is rather worse of late years, but she had not thought it bad enough to mention until her attention was called to it by questions. Her station is per- fectly good, her pupillary reactions normal; the knee-jerk decidedly slow and small, a little better on the left than on the right; on the right there is no ankle-jerk, on the left the ankle-jerk is present. There is muscle-jerk in both arms and in the left leg, but none in the right leg. Galvanic and faradic reactions are normal, and there is no altera- tion in sensibility. The state of things presents a somewhat mixed character, which were it not for its very long duration, the absence of eye-symptoms and of pains one might incline to think preataxic; but if it were of tabetic nature it would be symmetrical and would not present entirely different qualities of knee-jerk upon the two sides, as it does, in these respects resembling rather the ataxic paraplegia of Gowers than true tabes. Her gait shows no abnormality whatever, but I incline to the belief that the repeated attacks of her earlier life have in some way definitely altered the lower segments of the spinal cord and impaired the control of the legs. There is no trouble with the functions of the bladder, rectum, or uterus.