. Medical and surgical therapy. Fig. Fig. 15. Figs. 13, 14 and 15.—Hypotonus of the right quadriceps in acase of reflex paresis of the muscles of the leg and foot followinga shrapnel wound of the thigh (September 1914). Markedvaso-motor symptoms and hypothermia. Mechanical hyper-excitability of the muscles of the foot and leg without obviousdisturbance of the electrical reactions (September 1910). 558 REFLEX NERVOUS DISORDERS Amyotrophy We have already stated that amyotrophy some-times constitutes the most prominent feature of thecase. Thus traumatism or arthritis affecting the kneemay be
. Medical and surgical therapy. Fig. Fig. 15. Figs. 13, 14 and 15.—Hypotonus of the right quadriceps in acase of reflex paresis of the muscles of the leg and foot followinga shrapnel wound of the thigh (September 1914). Markedvaso-motor symptoms and hypothermia. Mechanical hyper-excitability of the muscles of the foot and leg without obviousdisturbance of the electrical reactions (September 1910). 558 REFLEX NERVOUS DISORDERS Amyotrophy We have already stated that amyotrophy some-times constitutes the most prominent feature of thecase. Thus traumatism or arthritis affecting the kneemay be followed by very pronounced atrophy withoutthe paresis being very pronounced. On the otherhand, paresis and contracture may be well developedand the amyotrophy be only of secondary importance. The following figures show the degree of diminutionin the size of the muscles. The circumference of theaifected leg is 3 to 6 centimetres smaller than that ofthe sound leg. In the thigh the difference is frequently 3 to 5 cen-timetres and someti
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