Diseases of the nervous system - a text-book of neurology and psychiatry (1915) (14596112310)

Identifier: diseasesofnervo00jell (find matches)

Title: Diseases of the nervous system : a text-book of neurology and psychiatry

Year: 1915 (1910s)

Authors: Jelliffe, Smith Ely, 1866-1945 White, William A. (William Alanson), 1870-1937

Subjects: Mental Disorders Nervous System Diseases

Publisher: Philadelphia : Lea & Febiger

Contributing Library: Columbia University Libraries

Digitizing Sponsor: Open Knowledge Commons

Text Appearing Before Image:

Fig. 184.—Another level of the cord, showing gliomatous tumor ca\ity. majority of patients the loss is only a partial one, not an absolute one.Most cases if seen early enough will show only slight reductions—epicritic heat and cold are lost before protopathic heat and cold— 358 LESIONS OF THE SPINAL CORD sometimes the reverse is true, or thermo-anesthesia and analgesiamay be present on one side only. Again heat or cold alone may beaffected. Epicritic touch may be involved, but it is not usual. These sensory anomalies ma^^ be distributed over very small areas,rarely bulbous (mucous surfaces included), most often cervical; orthey may extend almost throughout the entire spinal axis from thetrigeminus to the cauda (loss of testicle pains, and analgesia of thebladder, etc.).

Text Appearing After Image:

Fig. 185.- -Syringomyelia, showing the dissociated loss of sensibility,sensibility to pain. Areas of loss of The areas of diminished or lost sensibility to heat and pain areusually bilaterally asymmetrical, not infrequently are they unilateralfor a time, then spread to the opposite side. They show the mostunique distributions. The distribution may be exquisitely radicular;again, it is predominantly segmental or metameric. Schlesingersmost recent researches speak for the segmental type of distributionfor the majority of the cases (Fig. 185). SYRINGOMYELIA 359 In the beginning, one frequently encounters the glove and stockingtypes of sensory changes. Later a whole limb will be involved; onemay get a girdle sensation. A hemianalgesia, or hemithermo-anes-thesia may be present. Allochiria is usually absent. The sensory changes usually take years to develop. This sensorydissociation is frequently preceded by paresthesise—burning pains,cold spots, neuralgic-like pains, etc. Position sense

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1915

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