Nervous and mental diseases . -volutions. Peri])heral sensory disturbancearising from cortical lesions is usu-ally of a paresthetic sort. There maybe some blunting of cutaneous, mus-cular, and joint sensations, l)ut persis-tent anesthesia is extremely rareexcept in bilateral lesions. Thedouble and complete representationof sensation has been sufficiently in-sisted upon (see p. 186). In Jack-sonian fits the initial symptom isoften a peculiar sensation or pain that is first thrown into spasm. Patients are frequentlv at a loss todescribe these sensations, and thev varv from slicrht discomfort or
Nervous and mental diseases . -volutions. Peri])heral sensory disturbancearising from cortical lesions is usu-ally of a paresthetic sort. There maybe some blunting of cutaneous, mus-cular, and joint sensations, l)ut persis-tent anesthesia is extremely rareexcept in bilateral lesions. Thedouble and complete representationof sensation has been sufficiently in-sisted upon (see p. 186). In Jack-sonian fits the initial symptom isoften a peculiar sensation or pain that is first thrown into spasm. Patients are frequentlv at a loss todescribe these sensations, and thev varv from slicrht discomfort or slio^htformication to severe pain and intense burning. Their distributionis segmental or functional and does not conform to the peripheralnerve-supply. They are tolerably uniform in quality and distributionin any given case. Exhaustion of the motor apparatus after severe, andparticularly after repeated, attacks of Jacksonian fits may lead to a paralysislasting several days or weeks and a mistaken idea of brain destruction. 13. liiiic fitrurfs to sliow tlie eii-croacbiueiit of waves of discharge in the cortex,beginning respectively in the arm, face, andleg centers. F, Face; B, arm; J, leg (afterBrissaud). (Centers F and B should be placedon the precentral gyre.) oca iized in or near the part 194 DISEASES OF THE BRAIN PROPER: Frotti another point of view cerebral symptoms are diffused or local-ized. The great majority of endocranial lesions are marked by headache,vertigo, vomiting, mental disturbance, and often by optic neuritis. Asthese do not necessarily depend upon the part involved, they have littlelocalizing value, but the presence of several of them is highly suggestiveof brain disease. Headache is a very usual symptom. It is pronounced in the caseswhich involve the meninges. Its importance in meningitis will be atonce recalled. In syphilitic cerebral disease it has a marked tendencyto come on toward night. Cerebral headaches are usually very intenseand very refractory to s
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