A contribution to the pathology of paramyoclonus multiplex (Friedreich's type) / by J. Ramsay Hunt.

  • Hunt, James Ramsay, 1872-1937.
Date:
1903
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Licence: In copyright

Credit: A contribution to the pathology of paramyoclonus multiplex (Friedreich's type) / by J. Ramsay Hunt. 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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    of fifteen years’ duration, the muscles were found absolutely nor- mal (Fig. 5). It is suggestive that in the muscular dystrophies and hypertrophies and in myotonia and in paramyoclonus multi- plex, which represent obscure affections of the muscular and neuromuscular systems respectively, muscle changes essentially similar should be encountered. Hajos’40 case of paramyoclonus multiplex with the electrical reactions of Thomsen’s disease is of interest as furnishing clinical evidence of this relationship. We are far from understanding the true significance of the relations existing between the peripheral motor neurone and the muscle fiber, tissues having a different structure and derivation and yet intimately related; the fate of the one resting entirely upon the integrity of the other—the so-called trophic function or influence of the anterior horn cells. In articular muscle atrophies, this trophic influence in some obscure way appears to undergo a reflex inhibition. In the Dark- schewitz case the muscle fibers had suffered a reduction of one half their natural size. As this trophic influence may under certain conditions be so perverted as to cause disintegration or atrophy of the muscle fibers, it is reasonable to assume the possibility of an increased trophic function with a resulting hypertrophy. If the Friedreich theory of the irritability of the anterior horn cells is accepted in explanation of the motor phenomena of paramyoclonus, these muscle changes may well represent a concomitant increase of the trophic function of these same cells, and this would constitute im- portant objective evidence of the spinal origin of paramyoclonus multiplex. BIBLIOGRAPHY. 1. Friedreich. “Paramyoclonus Multiplex.” Virchow’s Archiv, Bd. 86, S. 421. 2. Lowenfeld. “Paramyoclonus Multiplex (Friedreich).” Baierische Intelligenz-Blatt, 1883. 3. Remak. “Myoclonus Multiplex.” Archiv f. Psych., Bd. 15, S. 852. 4. Seeligmiiller. “Ein Fall von Paramyoclonus Multiplex (myoclonia congenita.)” Deutsche med. Wochenschr., 1886, No. 24. 5. Francotte. “Cas de paramyoclonus multiplex.” Annal. de la Societe medic, chirurg. de Liege, 1887. Ref. in Virchow-Hirsch. 6. Homen. “Un cas de paramyoclonus multiplex.” Archiv. de Neur., 1887. 7. Allen Starr. Journal of Nervous and Mental Disease, 1887. “The Paramyoclonus Multiplex.” 8. Bechterew. “Paramyoclonus Multiplex.” Archiv f. Psych., Bd. 19, S. 88.