Shortly, however, there was a relapse. Transferred to a hospital for chronic cases, the patient was unable to walk without assistance on account of complete paralysis of the leg. Insomnia, general tremor, and a bad stuttering developed, with a habit of starting in terror at the slightest noise.
Hypnotic treatment was followed by almost complete disappearance of the tremor. The patient began to sleep six or seven hours a night; nervousness diminished, and the stuttering slowly improved; but neither the paralysis nor the anesthesia of the left leg was affected by suggestion. The leg remained cold, livid, anesthetic, and flaccidly paralyzed to the hip. Though a slight improvement has since been produced by faradization, the patient still can walk only with assistance.
A man was injured in 1906 by the fall of a heavy weight on his back. In 1914 he went to France as a soldier, and eight months later was hurled into a shell hole so that his back struck the edge. He was rendered unconscious. Upon recovery of consciousness, the right leg was found to be swollen, and there were severe pains in the legs and back.
Since return home the patient had gone from one hospital to another, for the most part unable to walk, suffering from agonizing pain in the head and eyes, unable to sleep, and in the night subject to horrible waking dreams.
Chart 6
MINOR SIGNS OF ORGANIC HEMIPLEGIA
(LHERMITTE)
| I. | Hyperextension of forearm (hypotonia). |
| II. | Platysma sign: Contraction absent on paralyzed side. |
| III. | Babinski’s flexion of thigh on pelvis (spontaneous, upon suddenly throwing seated subject into dorsal decubitus). |
| IV. | Hoover’s sign: Complementary opposition (on request to raise paralyzed arm, presses opposite arm strongly against mattress). |
| V. | Heilbronner’s sign of the broad thigh (hypotonia). |
| VI. | Rossolimo’s sign: flexion of toes on slight percussion of sole. |
| VII. | Mendel-Bechterew sign: flexion of small toes on percussion with hammer of dorsal surface of cuboid bone. |
| VIII. | Oppenheim’s sign (extension of great toe on deep friction of calf muscles); or Schaefer, or Gordon (on pinching tendo Achillis). |
| IX. | Marie-Foix sign: withdrawal of lower leg on transverse pressure of tarsus or forced flexion of toes, even when leg is incapable of voluntary movement. |
At first able only to bring himself to an upright position and to rush a few steps, he later acquired considerable control of his feet and legs through crutches. The insomnia persisted.
Smyly regards this case, like [Case 116], as more neurological than mental.