Spasmodic wry-neck and other spasmodic movements of the head, face and neck / by Noble Smith.

  • Smith, E. Noble (Eldred Noble), 1847-1906.
Date:
1891
Catalogue details

Licence: Public Domain Mark

Credit: Spasmodic wry-neck and other spasmodic movements of the head, face and neck / by Noble Smith. 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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    “ in three places across the median line of the medulla oblongata, “ and thus connecting the spinal accessory nuclei of the opposite “ sides. The spinal accessory nerve is known to be the source “ of the motor fibres in the laryngeal branches of the vagus, “ and in the structural arrangement thus demonstrated by Dr. “ Clarke whereby the spinal accessory nuclei of the two sides “ are brought into close union with each other, we appear to “ have the explanation of the normal bilateral action of the “ laryngeal muscles.” Reference is made to Dr. Broadbent’s hypothesis that the muscles which act bilaterally as in the case of the larynx must have their central nerve nuclei “ so closely connected by com- “ missural fibres that the muscles of each side receive their “ nerve supply from both sides of the brain in proportion to the “ completeness of their bilateral action.” In the Pathological Transactions, vol. xxvi. p. 252, is described a case of Spasmodic Torticollis occurring in a fowl. Rotatory movements took place until the bird became exhausted, after which they would come on again. “ By placing the bird in a basket and fixing its head, the convulsions ceased.” A post-mortem examination was made, when “a large ecchy- “ mosed spot was found over the 2nd cervical vertebra, and three “ clots of blood about the size of millet seeds under the outer “ covering of the cord on the left side, but there was no apparent “ lesion of the cord. There was no disintegration.” The case was reported by Dr. Edwards Crisp. The spinal accessory nerve being that which is chiefly or alone involved, the disturbance must be either in the course of that nerve or in the spinal cord near its origin. The first onset of spasm may follow a severe nervous shock, or an accident involving a strain of the neck or a blow in that region, or exposure to a draft of cold air, or some other less local cause. In other cases no apparent cause exists, and then constitutional disease, such as Syphilis, Gout or Rheumatism, may be inquired for. Although typical Spasmodic Wry-neck is not supposed to occur before adult age, yet we may, I think, associate with this affection some cases which have occurred in childhood. In Childhood.—Dr. J. M. Coley, writing in the London Medical Gazette upon Wry-neck in children, recorded two cases of a spasmodic nature. One was in a boy aged eight, who had suffered for four days from “ involuntary painful contraction it *-he muscles of one side of the neck, which were almost (i continually drawing the head towards that side. The disease „ iac proceeded from cold, produced by the head resting several hours against a damp wall. The disease was ac- companied with quotidian fever.”