The Diagnosis of Nervous Diseases

Cover The Diagnosis of Nervous Diseases
The Diagnosis of Nervous Diseases
James Purves Stewart
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True ankle-clonus does not occur, but a pseudo- ankle-clonus is often met with. In a girl of 19, the subject of thread- worms and pruritus ani, this pseudo-clonus used to come on spontane- ously when sitting or standing at ease. One can often distinguish it from a true organic clonus by its irregular rhythm and by the peculiar upward start of the foot before it sets off on its first downward push. Further, pseudo-clonus is, as a rule, poorly sustained.
The superficial reflexes are sometimes dim
...inished, especially on the hemi-anaesthetic side. The pharyngeal reflex is frequently abolished. The plantar reflex in hysteria, if present, is always of the normal flexor type, never of the extensor or Babinski type. A persistent extensor plantar reflex only occurs in cases of disease of the pyramidal tracts, and in infants who have not learned to walk and in whom the pyramidal tracts are not yet myelinated.
The pupil-reflex to light is never lost in pure hysteria, though in rare cases it may be " concealed " by the presence of pupillary spasm.


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