Keeping him under observation for two weeks longer I finally sent
him to his home in the West, and am informed that he has since
remained perfectly well. It has seemed to me that many of the
cases recorded as paramyoclonus multiples have been really acute
palmus."
Gray mentions two cases of general palmus with pseudomelancholia,
and describes them in the following words:--
"The muscular movements are of the usual sudden, shock-like type,
and of the same extent as in what I have ventured to call the
general form. With them, however, there is associated a curious
pseudomelancholia, consisting of certain fixed melancholy
suspicious delusions, without, however, any of the suicidal
tendencies and abnormal sensations up and down the back of the
head, neck, or spine, or the sleeplessness, which are
characteristic of most cases of true melancholia. In both of my
cases the palmus had existed for a long period, the exact limits
of which, however, I could not determine, because the patient
scouted the idea that he had had any trouble of the kind, but
which the testimony of friends and relatives seemed to vouch for.
They were both men, one thirty-six and one thirty-eight years of
age. The pseudomelancholia, however, had only existed in one case
for about a year, and in the other for six months.
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