. Medical diagnosis for the student and practitioner. astic paraplegia withoutmental symptoms is thought by some to bedue to an imperfect development of thepyramidal tracts. In most instances, however,the disease is associated with instrumentaldelivery and seems to be due to actual injury. Backwardness of the child may first callattention to the condition, or there mayhave been repeated convulsive seizures. Thehead may seem badly supported, the child may not be able to sit up and shows no tendency to walk or creep at the proper rigidity and adductor spasm are usually marked. Symptoms a
. Medical diagnosis for the student and practitioner. astic paraplegia withoutmental symptoms is thought by some to bedue to an imperfect development of thepyramidal tracts. In most instances, however,the disease is associated with instrumentaldelivery and seems to be due to actual injury. Backwardness of the child may first callattention to the condition, or there mayhave been repeated convulsive seizures. Thehead may seem badly supported, the child may not be able to sit up and shows no tendency to walk or creep at the proper rigidity and adductor spasm are usually marked. Symptoms are commonly either absent or less marked in the arms; whenmarked it constitutes a spastic diplegia. Constant irregular larger movementsof a choreic type may be present in the extremities, sometimes most markedwhen coordinate movement is attempted, and pronounced bilateral athetosisis often present. Erbs Syphilitic Spinal Paralysis.—The leading features are slight mus-cular rigidity, exaggerated deep reflexes, pain and sensory disturbance trifling,. Fig. 619.—Littles {Gordon.) HYSTERICAL SPASTIC PARAPLEGIA—SYRINGOMYELIA 1259 involvement of the rectum and bladder, impotence, a slow onset and a certainamenability to treatment. HYSTERICAL SPASTIC PARAPLEGIA.—Hysterical persons canaccurately simulate true spastic paraplegia and differentiation is sometimesextremely difficult, but a few positive points can be laid down. Such are: spurious clonus, more marked and irregular disturbances ofsensation, variability in the site and intensity of paralysis, unsustained orirregular resistance to passive movements, frequently associated hysterical stig-mata and absence of the Babinski.
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1922
