Text book of veterinary medicine, Volume 3 (of 5)Law, James
Science
Text book of veterinary medicine, Volume 3 (of 5)
Law, James
Veterinary medicine
The muscles supplied by the inflamed nerves also rapidly degenerate. The
fibres shrink in size, and lose their striated appearance, becoming
distinctly granular, and pale. Round cells are formed in excess in the
sarcolemma and muscular fibre, and if the morbid condition persists
there is fibroid degeneration, cirrhosis and contraction.
_Symptoms._ In the absence of the subjective element of pain, which is
the most constant symptom in man, we must rely mainly on the exquisite
tenderness on pressure along the line of the nerve, but localized at
some particular point, on the swelling at such tender point and on the
loss of muscular power or even of sensation in the tissues corresponding
to its peripheral distribution. The muscles may be hypersensitive and
are usually flaccid if not from actual paralysis, still from the pain
which attends on their contraction. In some cases they are the seat of
clonic spasms or twitching. Under a current of electricity they show a
decreased irritability which bears a direct relation to the grade of
degeneration which has occurred in the nerve fibres. In cases of
deep-seated neuritis paralysis may be the only appreciable symptom. In
traumatic injuries like bruises of the seventh nerve or fracture of the
sacrum the local swelling and tenderness are marked initial symptoms,
upon which supervene the paralysis and atrophy of the muscles cut off
from full innervation. In neurectomy the tender swelling in the stump
which is still in connection with the nerve centre may amount to a
distinct neuroma, while the peripheral and detached portion of the nerve
steadily loses its irritability as shown by electric stimulus.
_Prognosis._ This will depend on the nature of the lesion. A single
transverse section of a nerve, without loss of substance may be repaired
in a few months, while with loss or degeneration of a considerable part
of its substance it may maintain a paralysis for years or even
permanently. Lesions due to slight bruises may recover in a few weeks,
while the more severe ones will persist for months or years. The
response to electric stimulus distal of the lesion, is a guarantee of
the absence of degeneration and a feature hopeful of recovery. Pressure
by bony displacement or neoplasia must be done away with as the first
condition of improvement in such cases. Rheumatic and gouty cases will
persist until these constitutional infirmities are corrected.
If the neuritis and paralysis have lasted for any length of time, the
degeneration of the muscles will keep up a degree of muscular weakness
(and if in the limbs lameness) after the repair of the nerve has been
completed.
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