. A text-book of medicine for students and practitioners . Fig. 183.—Muscular dystrophy. Promi-nence of the scapulae when the armsare hanging down. (Erlangen MedicalClinic.) If the patient walks we canoften recognize the disease ata distance at the first glanceby the peculiar gait. The up-per part of the body is can-icdbackward (lordosis of tlie lum-bar vertebne), and the gait iswaddling, since the pelvis canno longer be held properly bythe weak glutcei. On stooping. Fig. 184.—Juvenile muscular dystrophy. Insufficientclosure of the ejes. Myopathic facies. (Personalobservation.) and rising, the
. A text-book of medicine for students and practitioners . Fig. 183.—Muscular dystrophy. Promi-nence of the scapulae when the armsare hanging down. (Erlangen MedicalClinic.) If the patient walks we canoften recognize the disease ata distance at the first glanceby the peculiar gait. The up-per part of the body is can-icdbackward (lordosis of tlie lum-bar vertebne), and the gait iswaddling, since the pelvis canno longer be held properly bythe weak glutcei. On stooping. Fig. 184.—Juvenile muscular dystrophy. Insufficientclosure of the ejes. Myopathic facies. (Personalobservation.) and rising, the same symptoms are seen as have previously been described (). As a rule, in the Juvenile form the face is not involved, but we can PRIMARY DEGENERATIONS OF THE MOTOR TRACT 391 sometimes detect sliglit disturbariees of the facial muscles, especially defectiveclosure of the lids and inability to wliistie (Fig. 184). We once made theinteresting observation thai the adult brother of a young girl suffering fromjuvenile dystrophy showed these (congenital?) anomalies in the face fromearliest childhood, without showing any further indications of dystrophy. Bul-bar symptoms are as rare as in the other forms. It is of significance that theintercostal musclesand the diaphragmmay finally atrophy,and the consequentrespiratory disturb-ance may be thecause of death. The course ofjuvenile dystrophyis very chronic, likethat of all the otherforms. The diseaseprogresse
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