In some ways the endless movements of her hands and fingers--she
never ceases playing with her dress or her gloves or her
handkerchief--are vaguely reminiscent of those of athetosis, and on
the left side especially, if they become a little brisker, there
is slight hyperextension of the phalanges. She reads aloud in a
low, colourless, monotonous tone of voice, without punctuation or
accent, articulating the syllables defectively and slurring the
ends of the words. At the finish of each paragraph comes a halt, as
if from fatigue, and on command a fresh start is made with the same
careless indifference. As for the lower extremities, the tale is
identical. Mademoiselle R. cannot stand upright. She rests on
either one leg or the other. Her left foot is never flat on the
ground, but sometimes on the inner border, sometimes on the outer.
The faulty attitude is readily enough corrected, though she
declares she is ignorant of it. It is a sort of half clonic, half
tonic, tic of the foot, whose slowness is on a par with that of all
her other acts.
It is because clonic tics are so easily recognised that they are the
most familiar, but we must not ignore another variety--viz. the _tonic
tics_, corresponding to the tonic form of convulsion.
Tonic tic is of common occurrence in cases of mental torticollis. In
that disease rotation of the head may be sustained for a considerable
length of time without interruption, showing the permanent nature of the
muscular contraction. Strictly speaking, we are concerned not with a
sudden gesture, but with an attitude. Abundant evidence is forthcoming
to substantiate its mental origin, and it may therefore be described as
an attitude tic. Among other instances of tonic tics may be specified
the affection of the masseters known as mental trismus (Raymond and
Janet), or that continuous contraction of the orbicularis which keeps
the eye half closed, though it may momentarily disappear under the
influence of the will--a tonic blinking tic. O. and young J. have
already supplied examples of attitude tics, and reference may further be
made to another of our patients[49]:
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