Nervous and mental diseases . axicparaplegia by Gowers, progressive spastic ataxia by Dana, and is knownvariously as posterolateral sclerosis, combined posterior and lateral scle-rosis, and combined tabes, or sometimes as spasmodic tabes. Some casesshow a tolerably definite limitation of the sclerosis, suggesting a sys-tematic degeneration, but usually it is not strictly confined to the physio-logical tracts of the cord. For the most part the lesions are within theposterior half of the cords cross-section, and are commonly embraced in theposterior arterial field (see p. 336 and Fig. 126). Occa
Nervous and mental diseases . axicparaplegia by Gowers, progressive spastic ataxia by Dana, and is knownvariously as posterolateral sclerosis, combined posterior and lateral scle-rosis, and combined tabes, or sometimes as spasmodic tabes. Some casesshow a tolerably definite limitation of the sclerosis, suggesting a sys-tematic degeneration, but usually it is not strictly confined to the physio-logical tracts of the cord. For the most part the lesions are within theposterior half of the cords cross-section, and are commonly embraced in theposterior arterial field (see p. 336 and Fig. 126). Occasionally the lesion alsoencroaches upon the peripheral portion of the cord in front, which belongsto the anterior arterial field. The symptoms are dominated by ataxia andspasticity, and the tendency is progressively toward paraplegic helplessness. Etiology.—The causes of combined sclerosis are numerous. It mustbe at once recognized that this extensive symptom group is frequently DISEASES OF THE WHITE MATTER OF THE COED. 449. Fig. 196.—Combined posterolateral sclerosis. Schemelal area of cord-change limited to the pos-terior arterial field of the cord (Brissaud). diowii a secondary cord-process: (1) In a certain small number of cases,primarily tabetic, a diffuse myelitis also invades the lateral tracts; (2) itis found more frequently ingeneral paresis than are lesionsentirely confined to the pos-terior columns; (3) a diffusemyelitis gives rise to ascendingand descending degenerationsthat furnish a posterolateralsclerosis; (4) leptomeningitismay entail a marginal myelitisthat invades the periphery ofthe cord and principally affectsits posterior half; (5) vascularlesions, affecting principallythe posterior field, induce asclerosis in the posterior andlateral tracts; (6) pellagra some-times causes a combined pos-terolateral sclerosis; (7) toxic conditions, as in the pernicious anemias, may cause it; (8) the postero-lateral sclerosis may be evidence of an embryonic deficiency as
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