Postencephalitic respiratory disorders : review of syndromy, case reports, physiopathology, psychopathology and therapy / by Smith Ely Jelliffe.

  • Smith Ely Jelliffe
Date:
1927
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Licence: In copyright

Credit: Postencephalitic respiratory disorders : review of syndromy, case reports, physiopathology, psychopathology and therapy / by Smith Ely Jelliffe. Source: Wellcome Collection.

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    Barker and Sprunt’s case, reported in May, 1921, and Beriel’s short note before the second annual reunion of the Paris Neurological Society in June, 1921, are next in chronological order. This interesting case report of Barker and Sprunt2 first pre¬ sented in May, 1921, before the Association of American Physi¬ cians, which when studied with our own case, the work of Rosett on Hyperpnea and with the study of Adlersberg and Porges offers extremely suggestive material concerning the neurology of metabolism. The patient was a young man of eighteen; he had “hard attacks of breathing,” difficulty in sleeping and “ slipping spells.” The history given is very detailed and extensive, of which the authors themselves make the following summary: (1) Postencephalitic state with petit mal attacks, functional paroxys¬ mal hyperpnea, and a single spontaneous attack of tetany. The chief features of interest in the present connection are the acute hypomaniacal symptoms of the onset with diplopia, and fever in January, 1920. Later there were attacks of hyperpnea which in February, 1921, are described by the authors as “ very deep and labored respirations, the accessory muscles being brought forcibly into play.” This breathing does not interfere with the patient’s talking. The paroxysms lasted from 2 to 3 minutes. The attacks were divertible. He had many pimples on his face. During the examination made by Barker there was a definite bilateral carpal spasm, persisting for 15 to 20 minutes (Fig. 1). There was no involvement of the feet as did occur in Jelliffe’s case. Chvostek but no Poole-Schlesinger leg sign. The authors discuss especially the relationship of the tetanifonn spasm to the hyperpnea and lay much stress upon what they term the “ psychoneurotic element.” This paper deals particularly with the tetany and states that it is among the first to be reported. [See observa¬ tions made upon “ hysterical dyspnea ” with “ tetany ” in Loubry’s 1906 thesis, p. 44 et seq. 47, and Hall’s retrospective note, p. 5, of a case seen by him in 1903.] A general paper contributed by Barker4 later summarizing some of the more striking sequels or “ residuals ” of encephalitis, occurring in at least 70 per cent of the attacks. He here mentions Aronson’s case 2 Barker, L. F., and Sprunt, T. P. A Spontaneous Attack of Tetany During a Paroxysm of Hypernoea in a Psychoneurotic Patient Convales¬ cing from Epidemic Encephalitis. Endocrinology, VI, 1922, 1. Tr. Am. Physicians, May, 1921. 3 Adlersberg and Porges. Die neurotische Atmungstetanie, eine neue klinische Tetanieform. Vienna, 1924. 4 Barker, L. F. Sequelae of Epidemic Encephalitis. N. Y. State II. Med., XXII, 1922, 251, June.