Brain surgery . ith a closing of the fingersand thumb of the right hand and a twitching of the arm was then flexed and trembled, and the hand wasbrought to the face by a movement at the shoulder; theface upon the right side then began to twitch, and thehead turned slightly toward the right. At this point hewakened from his sleep, perceived a sensation as if hismouth were full on the right side, felt a slight numbnessin his cheek, but at the moment of waking the spasmceased. The spasm never extended to the leg or to themuscles of the other side of the body. The attacks never4 50 BRAIN
Brain surgery . ith a closing of the fingersand thumb of the right hand and a twitching of the arm was then flexed and trembled, and the hand wasbrought to the face by a movement at the shoulder; theface upon the right side then began to twitch, and thehead turned slightly toward the right. At this point hewakened from his sleep, perceived a sensation as if hismouth were full on the right side, felt a slight numbnessin his cheek, but at the moment of waking the spasmceased. The spasm never extended to the leg or to themuscles of the other side of the body. The attacks never4 50 BRAIN SURGERY. occurred when he was awake or in the day-time, but asmany as six have occurred in one night. Examination on February 19th, 1892, failed to revealany evidence whatever of disturbance of sensation ormotion. His mental condition was perfect, his eyes werenormal, and he had no symptoms to complain of. The condition was, therefore, one of pure Jacksonianepilepsy in the right hand developing subsequently to a. Fig. 22.—The Situation of the Opening made in the Skull in Case XI. blow upon the head, but without any permanent defect ofpower or sensation. The patient was trephined by Dr. McBurney, on Feb-ruary 25th, 1892, at St. Lukes Hospital. The openingwas two by one and one-half inches over the middle thirdof the fissure of Rolando, and exposing the adjacent cen-tral convolutions (Fig. 22). The bone was found to benormal, the dura was adherent to the bone, and a small,whitish plaque of connective tissue was found on the TREPHINING FOR EPILEPSY. 51 dura. The dura was not adherent to the pia, and thebrain appeared to be perfectly normal; no cyst and noremnants of a clot were found. The wound was closedand within two weeks the boy was as well as before theoperation. During the month of March he had six slight attacks,the face only being affected. During April he had oneattack; during June he had two attacks; since June hehas had no attacks of the former character. During Augus
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