A case of locomotor ataxy, without diseases of the posterior columns of the spinal cord / by A. Hughes Bennett.

  • Bennett, A. Hughes (Alexander Hughes), 1848-1901.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: A case of locomotor ataxy, without diseases of the posterior columns of the spinal cord / by A. Hughes Bennett. 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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    were of moderate size, tlie left somewjiat smaller than tlie right, and both contracted well to light and accommodation. The muscles of the face and tongue were as in health, and articulation, mastication, deglutition, and all the special senses were normal. The movements of the upper extremities could be all performed, but the grasp of the hands was weak, and delicate actions of the fingers were unsteady and shghtly inco-ordinated. The movements of the trunk seemed normal, and the functions of the bladder, rectum, and sexual organs appeared to be intact. The patient felt his lower extremities to be weak. He walked with a slow, unsteady, hesitating, and markedly ataxic gait. Without assistance he staggered, had difiiculty in turning or walking in a straight line. He could not stand on one leg, and all his motor difficulties were increased in the dark. When the eyes were closed the patient swayed and would have fallen if not supported. In bed the movements of the lower limbs were vigorous and displayed considerable force, but they were accompanied by the typical phenomena of inco-ordination. The knee jerk on both sides was totally absent and the plantar reflexes were diminished. There was very slight rigidity of the large joints, which was easily overcome by passive movement. The sensibility of the skin to touch and pain appeared to be everywhere normal, except in the feet and legs, where it was both diminished and retarded. The patient complained of a constant dull aching in his back and lower limbs, and this was almost daily accom- panied by attacks of lancinating pains which shifted about from place to place, and which were sometimes very severe. The muscles throughout the body were thin and spare but nowhere specially atrophied ; their mechanical u'ritability and electrical reactions were unimpaired. The other organs and functions of the body were normal. The patient died after a residence of two and a half months in the hospital. From the beginning the weakness of the legs and insecurity of gait increased, so that in about six weeks he could not stand. The lancinating pains were very constant and severe. For many weeks there were attacks of uncon- trollable vomiting. Emaciation ensued and the general health broke up. During the last week the patient was feverish, restless, and prostrate; he became semi-comatose, and finally, after a severe convulsive attack, died. Otherwise no new or special symptoms developed. Post-mortem examination (30 hours after death).—Permis- sion was given to examine the brain and spinal cord only.