Diseases of the nervous system : a text-book of neurology and psychiatry . ients open their eyes after closingthem with difficulty. One of us has seen this as an initial symptom. 1 Furstner et al.; see Zingerle. 426 PARALYSIS AGITANS, CHOREA, RELATED DISORDERS The patients read with difficulty because of the stiffness of theocular movements. Ocular palsies may result—pseudo-ophthalmo-plegias. One occasionally finds slow pupillary reactions. The pharyn-geal and laryngeal muscles being involved, as others in the body, resultsin slow, difficult speech, becoming fainter and fainter as the years go
Diseases of the nervous system : a text-book of neurology and psychiatry . ients open their eyes after closingthem with difficulty. One of us has seen this as an initial symptom. 1 Furstner et al.; see Zingerle. 426 PARALYSIS AGITANS, CHOREA, RELATED DISORDERS The patients read with difficulty because of the stiffness of theocular movements. Ocular palsies may result—pseudo-ophthalmo-plegias. One occasionally finds slow pupillary reactions. The pharyn-geal and laryngeal muscles being involved, as others in the body, resultsin slow, difficult speech, becoming fainter and fainter as the years goby, until finally the patient, in addition to being unable to move, todress himself, eat without help, finally is unable to talk or to hypertonus and rigidity, however, is not associated with theusual increased reflex signs of pyramidal tract involvement, thereflexes are either normal, or only slightly exaggerated, no clonus,Babinski, Oppenheim, etc., and the contractures may be easily over-come by passive movements, in marked contrast to the contractures. Fig. 224.—Attitude of paralysis agitans patient. (T-ilney.) of psychomotor cortical origin. The muscular power is also not soinvolved, the patients show muscular weakness, but not is a striking contrast between the strength of active movementsand that of resistance movements. The former are weak, the latterrarely less than normal. A few cases of extensor rigidity are recorded, but it is predominantlyof the flexor muscles. With the rigidity there is a feeling of tension that the patients dis-like usually much more than the almost universal tremor. Thiscauses them to feel as though they were bound. Their motor impulseseems interfered with. This may even affect their urination anddefecation, and their deglutition. PARALYSIS AGITANS 427 Attitude.—This is that of a decerebellate rigidity in contrast to adecerebrate rigidity. Tremor.—In the majority of the cases this objective sign seems to beth
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