The coincidence of facial paralysis with acute anterior poliomyelitis / by G. A. Gibson and J. G. Cattanach.

  • Cattanach J. G.
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: The coincidence of facial paralysis with acute anterior poliomyelitis / by G. A. Gibson and J. G. Cattanach. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    9/16 (page 323)
    elicited by tapping the muscle. His right hand has cramp occasionally, but he attributes this to his trade—rope- spinning ; his hand being firmly closed on the hemp, which runs out as he walks backward. Others in the trade also complain of this cramp. The form and appearance of the spine present no peculiarity, and percussion is not painful. The appearance of the patient is well shown in the accompanying illustration. (Plate XVII.) The diagnosis of the case presented several points of difficulty. The lesion appeared to be nervous rather than myopathic. It bore some resemblance in distribution to the facio-scapulo-humeral form of muscular atrophy in infancy first described by Duchenne,^ but there had been no gradual •development. The facial paralysis was complete. Fibrillary twitchings were present, and there was a total absence of any true or false hypertrophy of the deltoid or other muscles such as are usually found in this type. The possibility of idiopathic muscular atrophy had therefore to be negatived. When the patient was first admitted, the distribution of the facial paralysis, and the statement that it had existed “ all his life,” rendered it possible that the case might be one of “ birth paralysis ” from obstetric inter- ference. The scar before referred to might have been caused by badly applied forceps, which would also in that position have damaged the brachial plexus. We may cite a case curiously like this from Duchenne’s works.^ In this case the child, delivered with forceps, was born apparently dead, and was resuscitated by artificial respiration. Thirty-six hours after birth it was noticed that there was facial palsy and paralysis of the left arm. Movement of the left upper limb was absolutely abolished, but there was apparently some slight sensibility. On examining the left side of the neck, there was a linear slough 1 cm. in length, which separated and left a wound in the cellular tissue, penetrating along the edge of the trapezius. This had been caused by J Selections from the clinical works of Dr. Duclieiine, “ New Sydenham Society,” London, 1883, p. 61. - Ibid., p. 211.