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

  • John Kearsley Mitchell
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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    Referring to the peculiar family affliction, I have to say that I have seen Mr. W. a number of times suffering with these mysterious attacks, though he has suffered but few in the last few years. The condition is surely a most singular one, never having seen any cases like his or his daughter's, and have never seen any authority covering these cases, Mr. W., I understand, has given you the details of his case, which are evidently very similar to . the attacks with which J. suffers. As to Mr. W.'s daughter, who is now about fifteen years of age, I have seen her in this peculiar condition but once, about oue year ago,_ although she has had two or three attacks since, but they were rather light. At the time I saw her she had gone to bed in the evening as well as usual, and on waking in the morning she found herself completely help- less—paralyzed. I was called and found her in this paralyzed condi- tion—could not move hand or foot. In all respects the attack was similar to those from which her father suffers, except that she suffered quite severe pains in back and head. All reflexes seemed weakened or absent. She remained in this condition ten or twelve hours, when she began to get better, and by the next day she could help herself and began to sit up. lu three or four days she was as well as usual. There does not seem to be any regularity in her attacks, nor do I think that menstruation has any relation to the attacks. I hardly think mental emotion or physical exertion are exciting causes. This young lady has been away from home several months attending school, and I have not heard of her having an attack recently. I forgot to say that in this case (Mr. W.'s daughter) I did not make a careful examination of the heart, only to note that the heart seemed all right. The electrical examinations are of great interest and have been often and carefully made by Dr. J. H. W. Rhein, electrician to the Infirm- ary for Nervous Diseases. In the first examination during an attack it was impossible to get any reaction either with faradic or galvanic currents in most of the muscles with the largest amount of currents bearable. With from 30 to 40 milliamperes slight response could be obtained in the anterior thigh muscles. It was impossible to complete the examination, on account of the pain caused. In examining a large pad was always placed over the sacral region and a small, interrupting electrode over the motor points of the muscle tested. The K. CL. C. contracture was always greater than the AN. CL. C. contracture. On the second day of the same attack it was possible to get contrac- ture here and there; for instance, the anterior tibial responded with 20 milliamperes, the posterior with 18 milliamperes, the sciatic nerves with 20 milliamperes, and the biceps of the leg with 30 milliamperes. No contraction of the rectus femoris could be obtained with less than 30 milliamperes. It was necessary to discontinue the examination, as the strong currents made the boy feel faint and decidedly affected his heart. In a second attack there was no faradic reaction whatever in most of the muscles. In the erector spinje muscles there was fair contraction
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