The examination of the electrical reactions of the muscles concerned in
a tic is a clinical method seldom, if ever, resorted to, and we can
scarcely expect it to yield decisive results from the symptomatological
aspect. As with the reflexes, it may happen that we cannot afford to
neglect its diagnostic significance in certain cases. For example, we
have had occasion to test its worth in studying the case of young J.,
whose trouble consisted in a clonic tic of elevation of the left
shoulder, and a tonic attitude tic of the left arm whereby it was firmly
applied against the body. No important alteration in electrical
contractility was discovered, although the response in the upper part of
the left trapezius--which, by the way, was more voluminous than on the
right--was brisker than in its fellow. On the other hand, the right
deltoid, sternomastoid, and pectoral, were more excitable than on the
left.
Here, of course, the evidence supplied by electrical examination only
served to confirm the knowledge gathered from other clinical sources.
VASOMOTOR AND SECRETORY AFFECTIONS
Disorders of the vasomotor system rarely fail to assert themselves in
the subjects of tic, but they do not in any wise differ from such as are
met with in the majority of "nervous" individuals. The average sufferer
from tic is emotional, and apt to betray his emotion by blushing for the
most childish reason. This symptom may be in itself trifling enough, yet
it may afford the earliest indication of mental instability the nature
and extent of which subsequent research will determine. It is even
conceivable that fear of blushing--the _ereutophobia_ of Regis--may be
at the bottom of certain gestures intended to conceal the heightened
colour the apparition of which is so humiliating. The form they assume
is generally a movement of the arm or hand over the face, to mask the
momentary discomfort, and while in most instances they are no more than
stereotyped acts, they may develop into full-blown tics.
In regard to secretory affections, we have frequently observed the
concurrence of hyperidrosis and emotional phenomena in those who tic.
Young J., S., P., are cases in point. The slightest exertion, the least
effort of attention, are followed by an extraordinary secretion of
sweat, entailing constant carrying of a handkerchief in the hand, and
ceaseless mopping of the forehead or temples. This performance becomes
stereotyped, and is gone through even when there is no perspiration at
all. Suppression of the handkerchief sometimes causes actual malaise,
but this injunction must never be forgotten if a cure is to be effected.
[Persons afflicted with tic often develop a sort of visceral instability
which betrays itself in indigestion, dyspepsia, constipation,
diarrhœa, and in every variety of dietetic and alimentary caprice.
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