. A text-book of medicine for students and practitioners . andin particular of that portion which supplies the cheek, complicating the glosso-pharyngeal ])aralysis. In other cases we have seen the degeneration attackfrom the start the entire distribution of the facial, gradually producing acomplete diplegia facialis. Sometimes, also, the ordinary symptoms ofbulbar paralysis are accompanied by disturbances in the area of distribution RARER FORMS OF CHRONIC BULBAR PARALYSIS 441 of the ocular nerves, proljably the result of degeneration of the correspondingnerve nuclei (see Fig. 1U7, page 4157).
. A text-book of medicine for students and practitioners . andin particular of that portion which supplies the cheek, complicating the glosso-pharyngeal ])aralysis. In other cases we have seen the degeneration attackfrom the start the entire distribution of the facial, gradually producing acomplete diplegia facialis. Sometimes, also, the ordinary symptoms ofbulbar paralysis are accompanied by disturbances in the area of distribution RARER FORMS OF CHRONIC BULBAR PARALYSIS 441 of the ocular nerves, proljably the result of degeneration of the correspondingnerve nuclei (see Fig. 1U7, page 4157). What seems very remarkable is that tlie process may sometimes be confinedentirely to the ocular muscles. A. von Graele named this condition progressiveophthalmoplegia. Another name is anterior bulbar paralysis. In this forma bilateral paralysis of all the external ocuhu- muscles progresses with extremeslowness and is perfectly symmetrical. Tiie movements of the eye are thereforeimpaired in all directions. Diplopia is very rarely present. The pupil reacts. Fig. 198.—Progressive ophthalmoplegia. Paralysis of both eyeballs with bilateral of both facial nerves. (Erlangen Medical Clinic.) i<» light, and almost always the power of accommodation is preserved. Finally,both cyehaJIs hcconu! absolutely molioidcss. and llicre is a well-marked thoughincomplete ptosis. ^Fbere is, l)eyond a doubt, a progressive degeneration of thenuclei ;uid (ibcrs of the coi-responding nerves—that is, the abdueens and motoroculi; but with these the process may stop, spreading no farther. We have 442 DISEASES OF THE NERVOTS SYSTEM ourselves lately met with a patient who presented total bilateral ophthalmo-plegia, in whom the conditinii had existed without the slightest change forlifteeu years. Besides the oculomotor paralysis the muscles of the face () and even those of the body are sometimes involved. On the other hand,in a few cases the process seems to be limited to only a p
Size: 1539px × 1624px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, bookidtextbookofme, bookyear1912
