Neuralgia and the diseases that resemble itAnstie, Francis Edmund
Science
Neuralgia and the diseases that resemble it
Anstie, Francis Edmund
Neuralgia
In this country, however, there is as yet no disposition to give up the
phrase locomotor ataxy, and it only remains to define with sufficient
care the class of cases to which the word is here meant to apply. The
disease is understood to depend upon a degeneration of the spinal cord,
of which the following description is given by Lockhart Clarke:[50] "In
true locomotor ataxy, the spinal cord is invariably altered in
structure. Its membranes, however, are sometimes apparently unaffected,
or affected only in a slight degree; but generally they are much
congested, and I have seen them thickened posteriorly by exudations, and
adherent, not only to each other, but to the posterior surface of the
cord. The posterior columns, including the posterior nerve-roots, are
the parts of the cord which are chiefly altered in structure. This
alteration is peculiar, and consists of atrophy and degeneration of the
nerve fibres to a greater or less extent, with hypertrophy of the
connective tissue, which give to the columns a grayish and more
transparent aspect; in this tissue are embedded a multitude of corpora
amylacea. Many of the blood vessels that travel the columns are loaded
or surrounded to a variable depth by oil-globules of various sizes. For
the production of ataxy, it seems to be necessary that the changes
extend along a certain length, from one to two inches of the cord. The
posterior nerve-roots, both within and without the cord, are frequently
affected by the same kind of degeneration, which sometimes extends to
the surface even of the lateral columns, and occasionally along the
edges of the anterior. Not unfrequently the extremity of the posterior
cornua, and even deeper parts of the gray substance, are more or less
damaged by areas of disintegration. The morbid process appears to travel
from centre to periphery, that is, from the spinal cord to the posterior
roots. In the cerebral nerves, on the contrary, the morbid change seems
to travel in the opposite direction, that is, from the periphery toward
the centres. From the optic nerves it has been found to extend as far as
the corpora geniculata, but seldom as far as the corpora quadrigemina.
With the exception of the fifth, seventh, and eighth pair, all the
cerebral nerves have occasionally been found more or less altered in
structure."
The symptoms which occur in cases in which the above are the morbid
appearances found after death are (roughly speaking) as follows:[51] "A
peculiar gait, arising from want of co-ordinating power in the lower
extremities, a gait precipitate and staggering, the legs starting hither
and thither in a very disorderly manner, and the heels coming down with
a stamp at each step."
No true paralysis in the lower extremities or elsewhere. Characteristic
neuralgic pains, erratic paroxysmal in the feet and legs chiefly--pains
of a boring, throbbing, shooting character, like those caused by a sharp
electric shock.
Public-domain text, read in full here on John Shaqi.
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