Retrobulbar neuritis and facial palsy occurring in the same patient : with cases / by G. E. de Schweinitz.

  • De Schweinitz, G. E. (George Edmund), 1858-1938.
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: Retrobulbar neuritis and facial palsy occurring in the same patient : with cases / by G. E. de Schweinitz. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    consulted me, after a period of moderate right-sided headache, the sight of *the right eye began to fail rapidly. She denied menstrual difficulties, either at this time or at any previous time in her history, and gave no very clear account of exposure to cold or draft, although she was accustomed to sit near an open window while sewing. Knee-jerks and station normal; no tremor; there was no anesthesia and the inteliection was good. Examination.—The girl was rather pallid, but gave no evidence of organic disease. The vision of the right eye equaled seeing the movements of the hand in the upper field. The disc was a vertical oval, of pallid hue; both sets of vessels were slightly diminished and there was a strong venous pulse and faint retinal veiling. There was distinct pain above the eye and on movement. The center of the visual field was occupied by a large scotoma. The vision of the left eye, after the correction of a mixed astigmatism, was 6-6, the accommodation normal, and the ophthalmoscope showed a rather pallid disc, and vessels smaller than normal. There were no traces of the former facial palsy except twitching of the right orbicularis and of the muscles at the angle of the mouth on the right side. The usual treatment for retrobulbar neuritis, for practically all of the classical signs of this condition were present, was instituted, and after a vigorous course of iodide of potassium, and bichloride of mercury, with counter-irritation to the temple, and later full doses of strychnine, the vision gradually improved, and by the 25th of July had risen to 6-12 in rhe right eye, or fully one-half of normal. At this time confusion of vision began upon the left side, preceded as before by pain in the brow and tenderness in the orbit. The disc appeared paler upon the temporal side than at previous visits, the veins being about normal, but the arteries small. The vision sank to- 6-12, the accommodation failed, but a positive scotoma could not be demonstrated. Under ascend- ing doses of iodide of potassium the vision rapidly improved, and from that date until the present time there has been no re- lapse, and now normal vision is restored to each eye and the patient has returned to her occupation. Case II.—Miss Anna K., aged 20, consulted me on Sep- tember 29, 1896, for relief from keratitis. History.—The patient's parents are healthy Germans, and the girl herself gives no history of severe illness or constitu- tional complaint other than much discomfort during menstrua- tion. In 1893 she had an attack of sclero-keratitis of the right eye and soon afterwards facial palsy of the right side, which lasted for six weeks and disappeared under the influence of al-