The Hahnemannian monthly . The atrophy associated with the stiffness of the muscles pro-duces a slightly cramped appearance of the lower face thatmakes one resemble, as M. Marie says, a child about to , again, the fibrillary twitching is very apparent. Occa-sionally may be seen this peculiar twitching of one lateral halfof the tongue, while the other half rests quiet, proving thebeginning degeneration of the hypoglossal nucleus on the cor-responding side in the medulla oblongata. As the spinal centreof the motor root of the trigeminal nerve becomes involved,spasticity, fibrillary twitc
The Hahnemannian monthly . The atrophy associated with the stiffness of the muscles pro-duces a slightly cramped appearance of the lower face thatmakes one resemble, as M. Marie says, a child about to , again, the fibrillary twitching is very apparent. Occa-sionally may be seen this peculiar twitching of one lateral halfof the tongue, while the other half rests quiet, proving thebeginning degeneration of the hypoglossal nucleus on the cor-responding side in the medulla oblongata. As the spinal centreof the motor root of the trigeminal nerve becomes involved,spasticity, fibrillary twitching and atrophy progressively occurin the lips, the muscles of the lower face and the massetermuscles. The lips become separated, and apparently roll open;furrows and ridges appear about the lower jaw, marking the 1899.] Amyotrophic Lateral Sclerosis. 349 sections of muscular atrophy, and the lower jaw drops, forcingthe mouth open from the paralysis of the masseter muscles. Fig. Fig. 3. Qj: M ?. wjiv ^K»;>v wt ^mt eSBSk\ ;•_ - jflr The speech, too, becomes difficult, thick, and the words in-distinguishable, from the loss of the use of the tongue. It 350 The Hahnemannian Monthly. [June, would take many pages to describe in detail the different condi-tions found in amyotrophic lateral sclerosis; but the object ofthis article is not to go into detail, rather to give the grossersymptoms that will aid in the separation of this disease fromthe other forms of spinal atrophy, and to expose the existenceof the pathological cause in the spinal cord. One thing, how-ever, must not be forgotten, which is more prominent in thisform of spinal disease than in any other, that the paralysis isout of all proportion to the amount of muscular atrophy. As the degeneration progresses in the region of the medulla,the spinal centre of the pneumogastric nerve is attacked, andthe respiratory organs are involved; the stomach becomesirritable, palpitation becomes frequent, and fi
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