In typhus fever boring headache, oppressive rather than lancinating, is a feature of the first days. It is usually frontal or temporal.
In malignant tertian the headache is often quite intense during the prolonged hot stage. The headache of malaria is usually frontal or suboccipital.
In trench fever we may have a cutaneous hyperaesthesia over the shins. Rocky Mountain fever shows joint pains.
Tremors and Convulsions
It is in trypanosomiasis that we have the most important tremor. It is the fine tremors, which first are noticeable in the tongue and later in hands and even legs, that mark the onset of the stage of sleeping sickness with the trypanosomes in the cerebro-spinal fluid. At times an intention tremor may be noted in advanced cases of sleeping sickness. In addition we have epileptiform seizures in sleeping sickness.
In cerebral manifestations of pernicious malaria there is a type characterized by epileptiform convulsions.
In the acute stage of Brazilian trypanosomiasis we may have almost any type of cerebral or cord lesion.
Tremors of tongue and hands may be present in the second stage of pellagra.
Fibrillary tremors have been noted in the main-en-griffe of beriberi but tremors of the tongue and hands, so common in alcoholic neuritis, are rare in beriberi.
Convulsive seizures are not uncommon in the hyperpyrexial type of heat stroke.