Uniradicular palsies of the brachial plexus / by E. Farquhar Buzzard.

  • Sir Farquhar Buzzard, 1st Baronet
Date:
1902
Catalogue details

Licence: In copyright

Credit: Uniradicular palsies of the brachial plexus / by E. Farquhar Buzzard. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    On examination, the man, though slightly pale, presented the appearance of good general health and muscular development. The signs of disease consisted in atrophy and paralysis of the right supraspinatus, infraspinatus, deltoid and teres minor muscles, and in disturbance of sensation over an area roughly covering the deltoid muscle (see figs. 1 and 2). The atrophy in the spinati and teres minor muscles was extreme, and no response was obtained to faradic or galvanic currents; a few fibres of the deltoid responded to strong currents, whilst the greater part of the muscle was unresponsive. The right biceps was no larger, and perhaps a trifle weaker, than the left, but it reacted well to stimulation by electricity. No affection of the supinator longus or brachialis anticus could be detected, nor of the trapezius, rhomboids, serratus magnus, pectorales, or diaphragm. It was not possible to detect any defect in function in the subscapularis. As regards sensation, the area depicted in fig. 1 was quite analgesic; touches were felt there, but seemed different, according to the patient, to touches elsewhere; heat and cold sensibility was very defective over the same part, and the man thought he recognised heat with more difficulty than cold. Elsewhere the neuro-muscular system was normal, and no signs of visceral disease could be detected. After some weeks of treatment by massage and galvanism, symptoms of improvement began to set in with regard to the deltoid; and at the end of February, 1902, that muscle displayed very considerable voluntary power. A few fibres of the infraspinatus again began to function under volitional stimuli, and the area of analgesia was almost gone. The patient left the National Hospital early in March with a useful limb and with improvement still taking place. In this case no etiological factor could be obtained from the man’s previous history, and it is extremely unlikely that the trauma mentioned had anything to do with the condition. It may be added, however, that at the time of onset he was working very hard on half rations of food. No fever was associated with the early days of the disease. Case 2.1—A. 0., a married woman, 40 years of age, came to the Hospital in February, 1901, and was treated as an out-patient under the care of Dr. Beevor. She came complaining of weakness in her right hand, and gave the following history. i This case was shown by the author at the Neurological Society in March, 1901.
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