. Diseases of the nervous system : for the general practitioner and student. psule has a plaque of sclerosis, hemiplegia will follow As the essential feature of the sclerotic process is its dissemination invarious portions and at various levels of the central nervous system, acombination of symptoms of all the diseases mentioned is expected. In DISSEMINATED SCLEROSIS 297 fact there are several clinical forms of multiple sclerosis. They dependupon the predominance of one or another group of symptoms There is, however, a series of symptoms which are very frequentlypresent in this disease and wit
. Diseases of the nervous system : for the general practitioner and student. psule has a plaque of sclerosis, hemiplegia will follow As the essential feature of the sclerotic process is its dissemination invarious portions and at various levels of the central nervous system, acombination of symptoms of all the diseases mentioned is expected. In DISSEMINATED SCLEROSIS 297 fact there are several clinical forms of multiple sclerosis. They dependupon the predominance of one or another group of symptoms There is, however, a series of symptoms which are very frequentlypresent in this disease and without which a diagnosis of multiple sclerosisis almost impossible. If they are not all always present, at the same timesome of them at least will help to decide the diagnosis. They are: 1. Tremor.—It is of a special character: it appears only upon a volun-tary act. It is an intention tremor. Should the patient, for example,attempt to carry a glass of fluid to his mouth, he is bound to spill it, andthe nearer he gets it to his mouth the more the tremor will be pronounced,. Fig. 100.—Plaques or Sclerosis in Pyramids and Various Nuclei. (Original.) so that the glass will strike the mouth and the teeth in all directions andhe will fail to drink the contents. Writing is one of the first acts in whichtremor is manifested: at first all the letters are irregularly, unequallyseparated and placed at different levels. In a more advanced statewriting is illegible and then impossible. The legs, the trunk and the headmay also be affected by tremor, but this is more rarely met with. Thetremor may be at first unilateral or predominate on one side, later it becomesgeneralized. Not only upon voluntary acts irregular jerky movements are observed,but sometimes jerky spontaneous acts take place, such as sudden cryingor laughing. They occur without any relation to a preceding emotion. 2. Disturbance of Speech.—The patient speaks slowly, pausingbetween words and between syllables. In advanced ca
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectnervous, bookyear1913
