The symptom-complex of the acute posterior poliomyelitis of the geniculate, auditory, glossopharyngeal and pneumogastric ganglia / J. Ramsay Hunt.

  • Hunt, James Ramsay, 1872-1937.
Date:
1910
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Credit: The symptom-complex of the acute posterior poliomyelitis of the geniculate, auditory, glossopharyngeal and pneumogastric ganglia / J. Ramsay Hunt. 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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    persisted for a considerable time. They were localized in the left side of the throat and the left ear. The pulse-rate was high during the active period of the disease. There was no hiccough, nausea or vomiting. The patient had indulged excessively in the use of cigarettes for a number of years, so that the tachycardia may have had this etiology. I do not believe, however, that involvement of the pneumo- gastric can be entirely excluded. I would interpret the case as one of posterior poliomyelitis involving the glossopharyngeal and geniculate ganglion.* In the following case, recorded by Eaynand,^'^ there were associated herpes pharyngis, oticus, and facialis, with facial palsy, deafness, and abducens paralysis. Case 1C.—A woman, aged 52; sudden onset May 2, 1875, with fever, and angina. On May 6, still fever, deglutition painful and difficult. Examination of the throat revealed an herpetic eruption limited to the left half the soft palate and the anterior pillar of the same side. On May 7, several plaques of vesicles ap- peared on the left auricle, also a few vesicles on the left side of the face. Other vesicles were situated on the concha and in the auditory canal. On May 8 there was a left facial palsy with hemianesthesia of the left side of the face, also a small vesicle on the conjunctiva just above the cornea. There was also a distinct paralysis of the left external rectus, and absolute deafness on the left side. From this time the symptoms remained stationary, but later the abducens palsy disap- peared and sensation returned to the left side of the face. The herpes disappeared in twelve days, but the facial palsy persisted with disappearance of the electro- muscular contractility. Comment.—This is the only case among the eighty-seven of my series, in which mention is made of an ocular palsy in combination with facial paralysis or acoustic symptoms. Case 17.—Observation by C'hauveau.“ A woman, aged 42. Sudden onset with fever, headache, sore throat and moderate dysphagia. A few hours later severe lancinating pains with tinnitus aurium in the left ear. Examination showed an herpetic eruption on the left tonsil, left side of the palate and uvula; none on the larynx. The auricle and auditory canal were free from eruption; but two vesicles were seen situated on the posterior jjart of the tympanic membrane. There was also a herpes labialis. Comment.—In this case the eruption in the ear and throat is situated within the somatic and splanchnic zones of the glossopharyngeal ganglia. * A few days ago I saw a ease of Herpes Zoster Oticus and Pharyngis, loith Facial Palsy, Bypoacousis, and Bradycardia, through the courtesy of Dr. Charles H. Peck. The eruption was distributed in the external auditory canal, the concha, antihelix, and the fossa of the antihelix of the right ear. (Tympanum free.) In addition there were herpetic vesicles and erosions limited to the right side of the soft palate. The posterior half of the dorsum of the tongue on the right side was also red and swollen; innervation of palate normal. Sensation was diminished on the entire right side of the face, head and neck. Right corneal reflex was absent. Herpetic pains were severe. Diagnosis: Posterior poliomyelitis of the geniculate and glossopharyngeal ganglia. 17. Observation by Raynaud: Cited by Desirat; Complications du Zona, These de Bordeaux, 1903, p. 20. 18. Chauveau, C.: Herpes du tympan avec un herpes guttural et labial, Ann. d. mal. de I’oreille, 1901, xxvii, 151.
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