. A treatise on the nervous diseases of children, for physicians and students. trifle subnormal, and in thespastic cases they become ex-aggerated. An unusual sensitiveness to sound (hyperacusis) is observed ata very early date, so that the child is startled by the slightest noise, by aclapping of the hands, etc. Oppenheim speaks of this symptom as an in-creased motor acoustic reflex. Convulsions may occur, but are not an integralfeature of the disease. After the lapse of a few months the mental impair-ment is distinctly increased and blindness becomes absolute, and the childlapses into a condi
. A treatise on the nervous diseases of children, for physicians and students. trifle subnormal, and in thespastic cases they become ex-aggerated. An unusual sensitiveness to sound (hyperacusis) is observed ata very early date, so that the child is startled by the slightest noise, by aclapping of the hands, etc. Oppenheim speaks of this symptom as an in-creased motor acoustic reflex. Convulsions may occur, but are not an integralfeature of the disease. After the lapse of a few months the mental impair-ment is distinctly increased and blindness becomes absolute, and the childlapses into a condition of extreme marasmus, in which it dies, as a rule, be-fore the end of the second year (Fig. 115a). We may sum up the chief symptoms as follows: (1) A mental impair-ment observed during the earlier months of life and leading to absolute idiocy.(2) A paresis or paralysis of the greater part of the body which may be eitherflaccid or spastic. (3) The reflexes may be normal, deficient, or increased.(4) A diminution of vision terminating in absolute blindness (cherry-red spot. Fig. 115.—Case of Amaurotic Family Idiocy, 14months old. Patient of Dr. Cotton, of Chicago,showing well-nourished condition of child inearlier stage of disease. 464 THE NERVOUS DISEASES OF CHILDREN. in the region of the macula lutea with subsequent optic nerve atrophy).(5) Marasmus, and a fatal termination, as a rule, at about the age of twoyears. (6) Unusual sensitiveness to sound (hyperacusis). (7) The appear-ance of the affection in several members of the same family. In some of the children I have noted nystagmus and strabismus. Afew other symptoms in addition to those described above have been men-tioned by Falkenheim. These are explosive laughter and disturbancesof deglutition. The former I have not observed, but it is very probable thatit may occur in some of the cases, and the latter may be taken to be anaccompaniment of the great mental and physical deterioration ; and the occur-rence of such bul
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