. Essentials of diagnosis. Arranged in the form of questions and answers prepared especially for students of medicine . he lower portion of the ascending frontal convolution of bothhemispheres, or the corresponding motor tracts in symmetricalsituations, will give rise to the symptoms of bulbar palsy: para-l3sis of the lips, tongue and throat. How is pseudo-bulbar palsy to be distinguished from true bul-bar palsy ?Pseudo-bulbar palsy, in contradistinction to true bulbarpalsy, is likely to be characterized by two distinct attacks, byslight asymmetry of distribution of the syniiDtoms, and by thea
. Essentials of diagnosis. Arranged in the form of questions and answers prepared especially for students of medicine . he lower portion of the ascending frontal convolution of bothhemispheres, or the corresponding motor tracts in symmetricalsituations, will give rise to the symptoms of bulbar palsy: para-l3sis of the lips, tongue and throat. How is pseudo-bulbar palsy to be distinguished from true bul-bar palsy ?Pseudo-bulbar palsy, in contradistinction to true bulbarpalsy, is likely to be characterized by two distinct attacks, byslight asymmetry of distribution of the syniiDtoms, and by theabsence of wasting. Pseudo-Hypertrophic Paralysis. What are the symptoms of pseudo-hypertrophic paralysis ? Pseudo-hypertropine paralysis is a congenital family-affection,transmitted through females but occurring more commonly in l^SEUBO-HYPERTROPllrC PARALYSIS. 297 males, usually appearing in childhood, and characterized byweakness and enlarged muscles, the fibers of which undergoatrophy, while the interstitial tissue increases. The muscles ofthe calves and the infra-spinati usually participate in the en- FiG. Pseudo-hypertrophic paralysis in two brothers. (Gowers.) largement in striking degree. Wasting of the latissimus dorsiand of the lower portion of the pectoralis major is gait has a peculiar oscillating character ; ascendingstairs is difficult, and the manner of rising from the floor ischaracteristic (Fig. 47) : the patient first gets on his hands andknees ; then extending the legs he stands upon his feet; finally,by supporting his hands upon his thiglis he manages to reachthe erect posture. Ultimately the muscles become reduced insize ; the electric reactions suffer quantitative changes, indica- 298 ESSENTIALS OF 47.
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