Common disorders and diseases of childhood / by George Frederic Still.

  • George Frederic Still
Date:
1909
Catalogue details

Licence: In copyright

Credit: Common disorders and diseases of childhood / by George Frederic Still. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    Moreover, the miners' nystagmus does not show, so far as I ]iave been able to ascertain, the unilateral predominance which is so striking a feature in the nystagmus of spasmus nutans. Lastly, tliis theory seems to assume that the head movements are secondary to the nystagmus ; whereas clinical experience shows that the head movements often precede the nystagmus, and occasionally no nystagmus appears at any time. Prognosis. Spasmus nutans usually passes off after a few months, leaving no ill effects; occasionally it lasts only from two to three weeks, more often it lasts from three to twelve months; it rarely lasts beyond the end of the second year. I have, however, seen nystagmus stUl present in one case at the age of four years. As already stated, I know of no special relation between spasmus nutans and epilepsy, minor or major ; indeed, I have not seen a single case in \A'hich the child has developed epilepsy either during the persistence of, or subsequently to, spasmus nutans. I suspect that the tradition of such an association has arisen from the description given by Ebert of cases of epilepsy with clonic jerking of the head under the same heading ' Spasmus seu Eclampsia Nutans ', an unfortunate confusion of disorders wliich differ widely both in their symptoms and in their course. In one of my cases a single convulsion occurred in the ten months during wliich spasmus nutans lasted, but it appeared to be an ordinary infantile convulsion such as any rickety infant may have, and no others occurred during the subsequent period of observation (five months). I have been asked several times whether the disorder will leave any injurious effect upon the intellect and I have kept notes in several cases of the child's progress in walking, in talking, and in intelligence. I have not found them more backward than other children, unless the degree of rickets happened to delay development, which it rarely did ; but spasmus nutans, being an index of nervous instabihty, is, I think, hkely to occur in children who vnR show nervous pecuHarities at a later age. (I am not alluding to imbecility, though there would seem to be some special hability to tliis disorder in Mongol imbeciles ; two cases in my series were ' Mongols ', and Dr. Thomson includes two cases in liis series of tliirty-five cases, and aUudes to another.) In several cases I have thought that the child, long after all trace of the disorder had disappeared, was a higldy nervous or eccentric child, without showing any lack of intelligence. One patient was sent to me subsequently for ' spitefuhiess and screaming ', another at the age of four years because it was ' so nervous and