Acute Infectious Polyneuritis

Sanctis, Adolph G. De; Green, Martin A.

doi:10.1001/jama.1942.02830170023005

Cited by 7 publications

(1 citation statement)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Outbreaks of presumed virus disorders of the nervous system during or in relation to outbreaks of poliomyelitis have been observed before (Ottonello, 1939;De Sanctis and Green, 1942;Stapleton, 1949). One occasionally hears of patients who develop some strange apparently infective neurological disorder after contact with poliomyelitis (Sandifer, 1950).…”

Section: Discussionmentioning

confidence: 83%

Mesencephalitis and Rhombencephalitis

Bickerstaff¹,

Cloake²

1951

BMJ

217

View full text Add to dashboard Cite

bursts of high-voltage delta activity in all right-sided leads with phase-reversal in the right temporal region. From the time of admission for four weeks there was a slow, steady deterioration, the ptosis becoming complete and the eyes Aixed except for some downward movement.Bilateral total paralysis of jaw, facial, palatal, and pharyngeal muscles resulted in inability to hold her mouth closed or to lift her head off the pillow. She was unable to swallow or to speak, and deafness was marked. The remainder of the body appeared unaffected and her mental state was quite clear, though to a casual glance she appeared moribund. Nasopharyngeal secretions had constantly to be sucked out, but she would often attend to this herself. She was fed by oesophageal tube twice daily, and the constantly threatening inhalational bronchopneumonia was combated by full chemotherapy and penicillin.After remaining in this state for three weeks, with numerous episodes of respiratory obstruction, each thought to be her lest, she made an indistinguishable sound, and three days later to our astonishment could enunciate recognizable words, while some movement returned to the eyes. After a week she was able to speak sentences, in 10 days was able to swallow fluids, and solids four days later; eye movements were limited only on upward gaze.There was a slow and uninterrupted improvement, but as she became more mobile it was apparent that, though eye movements were normal, and all the motor 'weakness had disappeared, she had developed a Parkinsonian facies with tremor of the head, ,and mild cogwheel rigidity of the limbs with tremor. The cerebrospinal fluid on March 31 was normal apart from the Lange curve, which read 4322100000.Her further progress was followed in the out-patient department, and the Parkinsonian features gradually disappeared. By February, 1950. there was slight immobility only of the face, and six months later she was in all respects quite normal.Comment.-On admission the sensory, cerebellar, and mild pyramidal signs were all on the same side, and, with the gross defects of conjugate ocular movem,nts, pointed to the main lesion being in the tegmentufi of the midbrain, with evidence of involvement of lower centres developing later. It was striking how, at the height of the illness, when the patient was unable to see, speak, swallow, or expectorate the secretions which could be heard rattling in her throat, her mental state was perfectly clear and the power in her limbs excellent. She was very eager to listen to the wireless, and her deafness necessitated its being extremely loud. It was an unforgettable sight to see an apparently moribund patient, her wireless set at full volume, occasionally turning on the motor of the sucker to clear her own nasopharynx.Case 2A male 36-year-old 'works inspector had a history of general malaise and recurrent frontal headache for seven days, and increasing drowsiness for two days during which both lids tended to droop. On March 21,

show abstract

Section: Discussionmentioning

confidence: 83%

Mesencephalitis and Rhombencephalitis

Bickerstaff¹,

Cloake²

1951

BMJ

217

View full text Add to dashboard Cite

show abstract

Postdiphtheritic Polyneuritis and Pseudodiphtheritic Polyneuritis

Roberts¹

1956

AMA Arch Intern Med

View full text Add to dashboard Cite

THE SUCCESSFUL treatment of acute polyneuritis due to various known diseases and of the acute polyneuritis of unknown etiology, known as the Guillain-Barr\l=e'\ syndrome, has been effectively enhanced by the use of cortisone and corticotropin. The use of these agents has resulted in dramatic and life-saving improvement, but it is still somewhat controversial. Some feel that their prolonged use may break through important antibacterial and antiviral immunologic defenses. The therapeutic problem is further increased when the etiology is obscure. This is particularly so if one is confronted with such a symptom-complex, with or without bulbar involvement, during the poliomyelitis season, when the latter cannot be definitely ruled out\p=m-\even in the presence of an acellular spinal fluid. I have recently encountered two patients with a diphtheritic or pseudodiphtheritic polyneuritis in whom the hormones were employed, primarily because of their progressively deteriorating states. Since I have been unable to find any pertinent information or review in the literature concerning this ther¬ apy as specifically employed in diphtheritic polyneuritis, this experience is now set forth. It is hoped that this report may serve as a reference to those who may subsequently be confronted with these considerations. The presentation of a negative response in the one proved patient needs no apology; it merely demonstrates the need for the earlier institution of hormonal treatment, if such therapy proves to be fruitful in the hands of others and is decided upon. The other pa¬ tient, who had ingested apiol and in whom throat cultures were negative, owing possibly to the combination of the long time-interval prior to her seeking medical help and the intervening penicillin therapy, would have been deprived of the salutory effects of corti¬ sone were it not for the fortuitous appearance of a severe penicillin or serum reaction neces¬ sitating its use. A brief review of the perti¬ nent diagnostics and current literature relating to this problem is included in the Comment. REPORT OF CASESCase 1.-A 38-year-old white caretaker was first admitted to the hospital on the ENT service on March 7, 1954. He complained of a severe sore throat of four days' duration and painful swallow¬ ing. Examination revealed an extensive grayish membranous exúdate over the posterior pharynx, tonsillar areas, and soft palate, with lymphadenopathy. The second of two throat cultures was high¬ ly suggestive of diphtheria, and he was transferred to a local contagious disease hospital. He had received penicillin prior to transfer.At the other hospital three nose and throat cul¬ tures were reported as negative for diphtheria and hemolytic Streptococcus. His temperature (106 F) rapidly became normal. The senior physician there did not feel that the patient had a clinical picture of diphtheria, and no antitoxin was administered. He was placed on a course of oxytetracycline (Terramycin) for five days. After 12 days, he was discharged with the diagnosis of acute pharyngitis....

show abstract

Onset of Guillain-Barré Syndrome Following Exposure to Mustard Gas

Chusid¹

1946

Arch NeurPsych

View full text Add to dashboard Cite

Acute Infectious Polyneuritis

Cited by 7 publications

References 6 publications

Mesencephalitis and Rhombencephalitis

Mesencephalitis and Rhombencephalitis

Postdiphtheritic Polyneuritis and Pseudodiphtheritic Polyneuritis

Onset of Guillain-Barré Syndrome Following Exposure to Mustard Gas

Contact Info

Product

Resources

About