Nervous and mental diseases . Fig. 158.—Hand in early amyotrophic lateral sclerosis, showing excavation of the interosseous spaces and flattening of palmar eminences. scapula?, and the distorted chest manifest the unsupported characteristic of the atrophy is its gradual invasion of a musclefiber by fiber, commonly preceded by fibrillary twitchings. Thesetwitchings are sometimes decidedly exaggerated, causing arhythmic jerk-ing movements of the hands and arms or twitchings of facial reflexes may be either abolished or more commonly increased inactivity. Early and rapid
Nervous and mental diseases . Fig. 158.—Hand in early amyotrophic lateral sclerosis, showing excavation of the interosseous spaces and flattening of palmar eminences. scapula?, and the distorted chest manifest the unsupported characteristic of the atrophy is its gradual invasion of a musclefiber by fiber, commonly preceded by fibrillary twitchings. Thesetwitchings are sometimes decidedly exaggerated, causing arhythmic jerk-ing movements of the hands and arms or twitchings of facial reflexes may be either abolished or more commonly increased inactivity. Early and rapid wasting is often marked by diminution andeven extinction of the reflexes in the affected muscle ; but, again, thereis often early rigidity and marked myotatic irritability, which lastthroughout the disease and persist even when the muscles are muchwasted, or reflexes at first exaggerated may disappear. The reason forthis variability has been already indicated. LESIOXS AXD DISEASES OF SPIXAL GRAY. 399 In the lower extremitie
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