The Hahnemannian monthly . tacks groups of mus-cles, or single muscles themselves, or even sections of muscles,marking the advance of the disease in the anterior horns. Inthe spinal form it usually attacks the muscles of the thumbs and 348 The Hahnemannian Monthly. [June, little fingers (thenar and hypothenar) first; then the interosseousmuscles of the hand, thrusting the phalanges into prominence,giving the hand much the appearance of a claw. From thehand the atrophy gradually creeps up the arm, and finally be-comes general. At the very onset of the atrophy a peculiarcharacter of fibrillary t
The Hahnemannian monthly . tacks groups of mus-cles, or single muscles themselves, or even sections of muscles,marking the advance of the disease in the anterior horns. Inthe spinal form it usually attacks the muscles of the thumbs and 348 The Hahnemannian Monthly. [June, little fingers (thenar and hypothenar) first; then the interosseousmuscles of the hand, thrusting the phalanges into prominence,giving the hand much the appearance of a claw. From thehand the atrophy gradually creeps up the arm, and finally be-comes general. At the very onset of the atrophy a peculiarcharacter of fibrillary twitching develops in the skin over theregion of the muscle involved. This is the announcement ofthe attack on the cells of the anterior horns, which is verymarked, and is most important because it often marks themuscle next to be attacked. In the bulbar form, or that form in which the medulla is theprimary seat of the pathological change, the muscles of thelips, the tongue and the throat are progressively attacked. Fig. The atrophy associated with the stiffness of the muscles pro-duces a slightly cramped appearance of the lower face thatmakes one resemble, as M. Marie says, a child about to , again, the fibrillary twitching is very apparent. Occa-sionally may be seen this peculiar twitching of one lateral halfof the tongue, while the other half rests quiet, proving thebeginning degeneration of the hypoglossal nucleus on the cor-responding side in the medulla oblongata. As the spinal centreof the motor root of the trigeminal nerve becomes involved,spasticity, fibrillary twitching and atrophy progressively occurin the lips, the muscles of the lower face and the massetermuscles. The lips become separated, and apparently roll open;furrows and ridges appear about the lower jaw, marking the 1899.] Amyotrophic Lateral Sclerosis. 349 sections of muscular atrophy, and the lower jaw drops, forcingthe mouth open from the paralysis of the masseter muscles. Fig. 2.
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Keywords: ., bookauthorhomopath, bookcentury1800, bookdecade1860, bookyear1865
