1895 American Journal of the Medical Sciences  
Spreading paralysis on the right side, commencing in the shoulder; Jacksonian epilepsy; absence of all the classical brain tumor symptoms; early amyotrophy without spinal lesions; change of electric reaction; operation; death.-(Dr. Carson.) P. McH., aged forty-six years, bora in Ireland, resident of Kansas, occupation horse-trainer, gives the following history: General health always good with the exception of chills and fever at various times six or seven years back. Always led an active life,
more » ... nd excelled m athletic sports. A little more than a year before the begin¬ ning of the present trouble he was thrown from a buggy and dragged about thirty yards. . Was not conscious at the time of an injury. One day, about six months before presenting himself for treatment, he noticed a weakness in the right shoulder, when, with some compan¬ ions, he attempted to vault a fence. On repeated examinations he found that, while the shoulder and arm were decidedly weak, the elbow-joint and wrist were still performing their functions, and the grip of the hand and the movement of the fingers were not impaired. One month later the arm became so weak and unsteady, and a few weeks later the grip of the hand so unreliable, that he was compelled to discontinue shaving himself. The whole arm and hand felt at times numb (sleepy), and the arm seemed, smaller. At this time he sought medical advice from a local physician. Treatment (chiefly bromides and galvanism) was of no avail, and was, therefore, soon abandoned. For several months the unpairment of power and the "numbness" continued to increase. Electrical treatment was resumed by his physician, the faradic current being applied to the affected member. This application was immediately followed by a spasm commencing in the index and middle fingers, which were flexed upon the palm, the thumb being thrown into the palm: then the spasm extended to the wrist, flexing it; then to the arm, flexing it and drawing it near to the chest. All of the flexed muscles of the fingers, hand, forearm, and arm to the shoulder were involved. The spasm was unattended with loss of consciousness, lasted about two minutes,.and resisted all attempts at reduction. Such attempts caused much pern and had to be discontinued. The arm remained absolutely useless for at least an hour afterward, when it gradually resumed its former condition. Again, during the afternoon of the same day, he had a second spasm a counterpart of that in the morning. During the time that elapsed "'°™ "rsfc attack to his entrance into the hospital, about three months, he had at varying intervals nine spasms of different intensity, but in all essentials like the first one. Some of them, he thought, had been
doi:10.1097/00000441-189502000-00002 fatcat:nkodhsdkszdq5ldp5yjrbljwqu