Diagnosis of disorders of the cerebellar apparatus / by Tom A. Williams.

  • Williams, Tom A. (Tom Alfred), 1870-
Date:
1910
Catalogue details

Licence: In copyright

Credit: Diagnosis of disorders of the cerebellar apparatus / by Tom A. Williams. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    labyrinth, the turning sensation and loss of equilibrum may be ac- companied by nystagmus or even conjugate deviation from stimula- tion of the oculo-motor nuclei which are intimately connected with the vestibular nucleus by means of the posterior longitudinal bundle. If the stimulus extends to the pneumogastric nucleus, nausea, vomit- ing, palpitations, dyspnea and even syncope may occur. Noises in the ears are very common, even when the irritation does not originate auricularly. These bulbar phenomena are very often characterised by the state of angoisse, with acute distress, horror and fear of im- pending death such as to resemble angina pectoris. The source of vertigo is detected clinically by its aggravation through putting into action of the organ at fault, and its cessation or improvement when that organ is at rest: thus labyrinthine vertigo diminishes when the patient is quiet in bed, ocular vertigo when the eyes are closed, vertigo of gastric origin when the stomach is at rest, cardiac vertigo when strain on the heart is diminished, and so on; while vertigo of central origin is not attenuated by any of these means in particular. The seat of this disorder need not be in the cerebellum itself; a lesion Jii any of its peduncles is as effective; so that in the case of intracranial neoplasm, vertigo is a localizing sign only in a very broad-sense. Thus the vertigo of insular sclerosis is usually due to patches situated in the pons or other brachium, rather than to a lesion in the cerebellum itself. The vertigo occasionally found in tabetics is really a peripheral one due to the implication of the vestibular nerve in the meningeal process which causes tabes of the posterior columns by implicating the posterior roots. When the labyrinthine impulses are thus inter- fered with, the test with voltaic electricity is applicable. This is performed by placing one pole of a galvanic battery over each mastoid process. In the normal individual, the head deviates, as soon as the current is closed, towards the positive pole; while there is fe.t ^ am disaggregations upon which Grasset largely based his schema can no longer be considered as supporters of his hypothesis, now that the work of Babinski, Sidis® and Bernheim® has shown the fallaciousness of the data by which they were explained; so that Grasset’s schema, like those concerning the centers for speech, is dangerous to the uninitiated in that it tends to make one force the facts to fit the fancy.