. A manual of diseases of the nervous system. omes a characteristic The arms are only invaded, inmost cases, some years after the legs, so slow is the course of thedisease. The intrinsic muscles of the hands (thenar, hypothenar,and interosseal muscles) are first attacked, and subsequently those ofthe forearm: sometimes the extensors and sometimes the flexors sufferfirst and most; while the supinator longus remains normal, and so dothe muscles of the shoulder, neck, and back. The affection, however,does not necessarily commence in the lower limbs, and the face maybe affected (Hoffmann
. A manual of diseases of the nervous system. omes a characteristic The arms are only invaded, inmost cases, some years after the legs, so slow is the course of thedisease. The intrinsic muscles of the hands (thenar, hypothenar,and interosseal muscles) are first attacked, and subsequently those ofthe forearm: sometimes the extensors and sometimes the flexors sufferfirst and most; while the supinator longus remains normal, and so dothe muscles of the shoulder, neck, and back. The affection, however,does not necessarily commence in the lower limbs, and the face maybe affected (Hoffmann). The atrophy is often symmetrical, but occa-sionally the muscles on one side waste first a,nd most. The claw-likedeformity of the fingers may result from the affection of the intrinsicmuscles of the hand. This is so rare in early life from any othercause that its significance is considerable, and almost distinctive whencombined with the deformity of the feet just mentioned. The ca,seshown in Fig. 173 was probably an example of this type. J. Fia. 173.—Advanced muscular atrophy, probably of the peroneal type.(Drawn by Dr. Spencer, from a photograph.) The affected muscles (especially in the hand) occasionally presentslight fibrillation. Their electric irritability is diminished sooner, and • Hoffmann, Arch. f. Psych., xx, p. 660j Joffroy, Gaz. Hebd., 1886, No. 18. t See Sachs, • Brain, Winter part, 1889. J lb was given in the first edition as an example of simple atrophy. The patientwas a man aged twenty-seven at the time of his death (in University CollegeHospital). No history of any analogous case in his family could be affection began at the age of fourteen, when his feet began to turn in so thathe walked on the outer side of the foot, and soon he noticed graduiil wasting ofthe legs, which slowly progressed, and about the age of twenty-four the arms alsobegan to suffer. When first seen, a few months before his death, the muscularatrophy was universal, an
Size: 2709px × 922px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, booksubjectnervoussystemdisease
