File:A treatise on the nervous diseases of children, for physicians and students (1905) (14761665176).jpg

Identifier: treatiseonner00sach (find matches)
Title: A treatise on the nervous diseases of children, for physicians and students
Year: 1905 (1900s)
Authors: Sachs, Bernard, 1858-1944
Subjects: Nervous system Children
Publisher: New York, W. Wood and company
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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e one case described byCharcot-Marie. Whether the cases described by Osier asoccurring in the Farr family of Vermont, which set in aslate as the age of forty-six in some of the subjects, belongto this category or not is questionable, as the cases werereported before this special type of progressive muscularatrophy was known. In both my cases a thorough drench-ing of the skin by exposure to wet was mentioned, but I can-not attribute any further importance to this fact than thatit may have helped to hasten a disease which was latent inthe systems of the boys. Diagnosis.—The diagnosis of this leg type, or neuralform, of progressive muscular atrophy rests upon the recog-nition of the early beginning of the disease and of its hered-itary or family character. Moreover, the paralysis begin-ning in the leg muscles, and spreading to the upper extrem- *The case appears to bear a close resemblance to the peroneal form, as well as toan hereditary spinal form. PROGRESSIVE MUSCULAR ATROPHIES. 365
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$66 THE NERVOUS DISEASES OF CHILDREN. ities is associated with slight changes in sensation in thelegs as well as in the arms. The occurrence of doubleclub-foot (not congenital) will help to make the diagnosisstill more certain. The disease will have to be differentiated from hereditary ataxia, fromchronic multiple neuritis, from poliomyelitis, and from the primary musculardystrophies. From hereditary ataxia the disease can be readily distinguished by theabsence of the peculiar unsteadiness in walking and standing, by normalelectrical reactions in cases of hereditary ataxia, and by the persistence of thereflexes in many of the cases of the peroneal form. From chronic multiple neuritis we can distinguish the leg type by thefact that pain plays an even greater role in most cases of neuritis ; that theatrophy is not steadily progressive, and that neuritis, of however long stand-ing, rarely leads to double club-foot; and furthermore, that neuritis is not aptto occur as a family affection.

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