A case of Landry's paralysis / by John Cowan, A. J. Ballatyne and D. MacDonald.

  • Cowan, John, active 1909.
Date:
[1909]
Catalogue details

Licence: In copyright

Credit: A case of Landry's paralysis / by John Cowan, A. J. Ballatyne and D. MacDonald. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    admission, the legs were moved on the bed. On 10th October all the reflexes had returned, and power generally was con- siderable. She was allowed out of bed on 8th November, and was walking fairly well by the middle of the month. The larynx, for obvious reasons, was not examined until 3rd October, but on that date Dr. Harrington reported that the cords were moving freely. The case is interesting from several points of view. The symptoms were entirely motor, save for the involvement of the second nerve, and affected more or less the whole of the central nervous system. The lower neuron was involved, but no atrophy of muscles or RD. occurred. The onset was subacute, the maximum palsy being attained in fourteen days, and recovery was rapid and complete. The sphincters were not involved, and sensation was everywhere normal. These phenomena negative a diagnosis of peripheral neuritis or acute anterior poliomye- litis, and seem to index the case as one of Landry's paralysis. The onset of the symptoms in this disease is usually more acute than was the case with Mrs. R, and the result is usually less fortunate. Dr. Buzzard considers that these cases are the result of a lymphatic intoxication, and treatment was conducted upon this supposition. Elimination was assisted, while injections of strychnine, as well as diffusible stimulants, were given freely. The most careful examination failed, however, to reveal any evident cause for the intoxication. The possibility of an infective condition was negatived by the help of the Sanitary Office; and the only apparent lesion in the viscera was a by no means severe catarrh of the respiratory passages. Landry's paralysis seems to be rare in Glasgow, as only one case is reported in the Society's Transactions, namely, that recorded by Dr. George Buchanan (1906, vol. vi, p. 82), who reviewed the literature on the subject up to date. Dr. Buzzard1 has recently made a further communication upon the subject. He states that he has found in three cases of this disease chromatolytic changes in the cells of the anterior cornua and of Clarke's column, and occasionally excentration of the nucleus, the changes being best marked in the lumbar region, while a little fatty degeneration was present in the nerve fibres of the cord and peripheral nerves. There was no definite evidence of neuroglial or vascular changes. He considers that the pathological lesions point to a spinal intoxication of lymphatic distribution; but the cause of the intoxication is still obscure. 1 Brain, 1907, vol. xxx, p. 1.