Shell-shock; unconsciousness: Dysbasia, in part hysterical, in part organic (?).
Case 399. (Hurst, May, 1915.)
A private, 29, was knocked over by a shell explosion December, 1914. He was unconscious two days, found that he could not move either right arm or left leg, got some power back shortly, but, if he tried to stand, experienced involuntary violent movements in the left leg.
April 1, 1915, response to questions was slow and speech slow. The right arm and grip were weak. If the left hand was clenched, there was an associated movement of the right hand; but on clenching the right hand, no associated movement was produced in the left. The musculature was equal on the two sides, and the tendon reflexes of the arms were brisk and equal. Light tactile stimuli were hard to localize. Movements of the left leg were somewhat weak, though the musculature was equal on the two sides. The knee-jerks were brisk, the left slightly brisker. Sometimes a well-marked ankle clonus could be obtained on the left side, but sometimes not. The plantar reflex was constantly flexor. Babinski’s second sign (combined flexion of thigh and pelvis) was well marked on the left side.
On attempts to walk, the left leg would move rapidly from side to side, round the point of contact of toes with ground. When a step forward was taken with the right leg, the left one dragged, and made irregular movements.
This gait seemed obviously hysterical. The patient was kept in hospital for a month. He was very easily hypnotizable, but even in deep hypnosis leg movements could not be controlled when he was told to walk. The first whiff of ether hypnotized but did not cure him.
On the whole, upon review, Hurst believes that there may have been organic brain changes, which (a) the associated movement of the paralyzed hand when the normal hand was contracting, (b) the slightly increased left knee-jerk, (c) tendency to ankle-clonus, and (d) Babinski’s second sign, may show.
Peculiar walking tic.