The medical diseases of children . when the child attempts tomake use of its limbs. The facial weakness is only very slight in mostcases ; the arms suffer more than the legs. Spasticity is more pro-nounced than the weakness, and contractures are very prone to movements, choreiform movements, athetosis, and tremor arecommon, and are probably due to involvement of the mid-brain. Inthe legs the spasticity is such that when the child is held up the feet •176 DISEASES OF THE NERVOUS SYSTEM cross one another, owing to adductor spasm, and the child walks ontip-toe with the legs cross
The medical diseases of children . when the child attempts tomake use of its limbs. The facial weakness is only very slight in mostcases ; the arms suffer more than the legs. Spasticity is more pro-nounced than the weakness, and contractures are very prone to movements, choreiform movements, athetosis, and tremor arecommon, and are probably due to involvement of the mid-brain. Inthe legs the spasticity is such that when the child is held up the feet •176 DISEASES OF THE NERVOUS SYSTEM cross one another, owing to adductor spasm, and the child walks ontip-toe with the legs crossed (cross-legged progression, Fig. 85). Thereflexes are those of spastic paralysis. Dysphagia may be present(infantile pseudo-bulbar paralysis). Blindness is rare. In severe cases rigidity of the spine may be noted from birth, andopisthotonos is occasionally so marked as to cause a mistaken diagnosisof posterior basic meningitis. A condition of pleurosthotonos in sucha case, under the care of Dr. Sutherland, is shown in Fig. Fig. 86.—Severe Cerebral Sclerosis in an Infant , showinc Pleurosthotonos. Mental development is commonly deficient owing to the affectionof the prefrontal lobes. It is very varying in degree, from slightbackwardness to profound amentia, and is not necessarily in anyrelationship to the amount of spastic paralysis. Thus, some casescome under supervision for their mental state, and only a carefulexamination shows that they belong to this group (spastic idiocy).Fits arc prone to develop. Speech is acquired late, and is apt to beindistinct and defective. Cerebellar symptoms, which may be present, are considered later. CONGENITAL CEREBELLAR DIPLEGIA 477 Diagnosis.—The severe cases of generalized rigidity in infants areto be differentiated from posterior basic meningitis by the absence ofacute symptoms (convulsions excepted) and of bulging of the anteriorfontanelle, and by the normal state of the cerebrospinal fluid. Wherethe condition is of a less gra
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatrics, bookyear1
