Case of Paralysis Agitans following Malaria

Abstract

Pain in stomach two hours after food, relieved by vomiting, improved since 1915 until recently. No unsteadirWss of walking and no sphincter disturbance.Present state: Visual acuity: Right, -; left, s1r on looking to right of fixation point, at that point vision almost nil. Fields: Loss of upper half and general constriction, with central scotoma. Fundi: Old atrophy. Argyll Robertson pupils. No ataxy. Deep pressure of calves very painful. Deep reflexes absent. X-ray suggests cicatrix from old ulcer or growth of stomach with delay in emptying of stomach. Wassermann reaction: Negative in blood. Cerebro-spinal fluid: No increase of cells, globulin in cerebro-spinal fluid. Blood count: Red cells, 3,700,000; himoglobin, 70 per cent.; white cells, 10,500.Case of Paralysis Agitans following Mal,4ria. By S. A. KINNIER WILSON, M.D.H. C., MALE, aged 35. Malaria in England in 1918; blood tested at special malaria hospital (Connaught Hospital). A month later had " kicking " and twitching movements of left side, which became less noticeable after May, 1919.In December, 1919, had weakness of left side and some slight stiffness of both hands. He began to stoop and to have difficulty in turning over in bed. By May, 1920, his right leg was also stiff.August, 1920: Tremor, chiefly of right hand, slowness of speech and difficulty in opening mouth.Examination: Slight weakness of left lower face. Spasm and rigidity of sterno-mastoids and trapezii. Tongue deviates to right. Mask-like face. Rigidity of trunk and proximal limb muscles. Pill-rolling tremor of hands. Paralysis agitans attitude and gait, with festination and retropulsion.Case of Epilepsy with Acromegaly and Unilateral Tumour. MALE, born November 27, 1895. Nothing neuropathic recorded in the family. This patient's history and present condition may be classified under three headings: his epilepsy, his unilateral tremor, and his dyspituitarism.Epilepsy: First fit at fifteen months, second three or four years later after that about every three months. Since admission to Lingfield Colony eight and a half years ago, he has had attacks of petit-mal every two or three months with epigastric aura, loss of consciousness without spasm lasting two.or three seconds in all, also three major fits in the last two years.

Encephalitis lethargica and the influenza virus. III. The influenza pandemic of 1918/19 and encephalitis lethargica: neuropathology and discussion

“…Stern saw no point, therefore, in speculating about the specific etiology, but was convinced that the epidemiological and pathological evidence contributed by Economo, himself and others was sufficient to establish the separateness of the two disorders, and that the relationship, if any, was quite complex and far from obligate. Influenza might act as an agent provocateur , according to Stern, but it was not specific; measles (Capaldo 1932), typhus (Nagtegaal 1927; Rabinowitsch 1928) and malaria (Wilson 1921) could also elicit EL-like symptoms. Indeed, the similarity of EL and a number of other encephalitides with no connection to influenza – Japanese encephalitis, poliomyelitis and post-vaccinal encephalitis – was indirect evidence for the frailty of the unitary EL/influenza hypothesis (Stern 1936).…”