. A manual of diseases of the nervous system. the formconsidered in the next section. But it must beremembered that there are intermediate caseswhich form links between the two chief cases described by Meryon must be regardedas examples of the pseudo-hypertrophic form (seep. 568), but they present many points of resem-blance to the simple atrophy described furtheron. Complications.—Congenital mental weakness,due apparently to defective development of thebrain, sometimes complicates pseudo-hypertrophicparalysis. In rare cases there have been indica-tions of some other morbid condition
. A manual of diseases of the nervous system. the formconsidered in the next section. But it must beremembered that there are intermediate caseswhich form links between the two chief cases described by Meryon must be regardedas examples of the pseudo-hypertrophic form (seep. 568), but they present many points of resem-blance to the simple atrophy described furtheron. Complications.—Congenital mental weakness,due apparently to defective development of thebrain, sometimes complicates pseudo-hypertrophicparalysis. In rare cases there have been indica-tions of some other morbid condition of the central nervous system^such as epilepsy. It is uncertain in what hght the slight occasionalaffection of the bladder is to be regarded, whether as an invasion ofthe vesical muscles or as a central complication. Yigoroux has recordeda case in which the symptoms of pseudo-hypertrophic paralysis werecombined with the peculiar rigidity of Thomsens disease. Of coursethe subjects of the disease are liable, like other children, to various. Fig. 164.—Enlarge-ment of the vastiand not of therectus. In this caseall other muscleswere below normalsize. PSEUDO-HYPEKTROPHIC MUSCULAR PARALYSIS. 577 affections of the nervous system; I have seen both chorea and polio-myelitis as merely accidental complications. Pathological Anatomy.—It is rare at the time of death for anymuscles to be actually larger than natural. Sometimes, however, theyare enlarged, and the fibres themselves have been found hypertrophied,just as they have been in excised parts. There has also been founda great increase in the nuclei, atrophy of the fibres, vacuolation,and division of fibres. Most of those that are affected are belowthe normal size. They are pale and yellowish in colour, and often, tothe naked eye, resemble perfectly masses of adipose tissue. Theresemblance is not merely one of aspect. As seen under the micro-scope, it may be difficult for the observer to realise that he is notlooking at a fatty tu
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