Nervous and mental diseases . spastic featuresare induced. These may be associatedwith disorders due to involvement of theanterior horn, producing the conditionsfound in amyotrophic lateral sclerosis, butthe face is usually unaffected. Involve-ment of the posterior columns causesataxia and incoordination. Tremors,cramps, fibrillation, choreoid movements,and various muscular twitchings are notinfrequent. Trophic Features.—The affected ex-tremities, in addition to the muscularatrophy, often present trophic disturb-ances, especially about the digits, similarto those in neuritis. Glossy skin, hype
Nervous and mental diseases . spastic featuresare induced. These may be associatedwith disorders due to involvement of theanterior horn, producing the conditionsfound in amyotrophic lateral sclerosis, butthe face is usually unaffected. Involve-ment of the posterior columns causesataxia and incoordination. Tremors,cramps, fibrillation, choreoid movements,and various muscular twitchings are notinfrequent. Trophic Features.—The affected ex-tremities, in addition to the muscularatrophy, often present trophic disturb-ances, especially about the digits, similarto those in neuritis. Glossy skin, hyper-trophic nails, increased or diminished per-spiration, and herpetic and bullous erup-tions are encountered. Cuts, burns, andabrasions heal badly or tend to permanentulceration. In this way paronychia causesthe nails to fall. Felon is rather com-mon, especially in the Morvan type, and causes mutilations of the fingers by the loss of several phalanges, un-attended, usually, by the slightest pain. Perforating ulcer is encoun-. Fig. 150.—Case of syringomyelia,showing atrophy over right scapulaand thorax and in right leg. Spinescoliotic. 398 DISEASES OF THE CORD PROPER. tered with some frequency. .Boils, abscesses, and other local infectionsare not rare. They all heal badly, produce extensive scars, and mavcause mutilations and deformities. A thickening and hardening of theskin, especially of the fingers, is common, and variations of Raynaudssyndrome are often added. The arthropathies are almost invariably represented. They affectthe spine by preference, and the articulations of the upper extremitiesmore frequently than those of the lower limbs. In some cases thebones are affected. They are fragile, readily fractured, and unite withdifficulty and with persisting callous deformities. In a few cases thehands have been enlarged, as in acromegalia, for which this disease hasbeen mistaken. They have even been found associated. The spinalarthropathies give rise to deviations of the v
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