The
fingers, including the thumbs, were usually widely separated and
extended, though they were sometimes slightly flexed. The hands
were continually in slow, methodic, quasi-rhythmic motion, never
remaining long in the same attitude. In grasping an object the
palm of the hand was used, it being difficult to approximate the
digits. The wrist-joints were also implicated, there being
alternate flexion and extension. In fact these odd contortions
affected the entire limb from the shoulder to the digital
extremities. When standing or walking the arms were held out
horizontally, as if to maintain the equilibrium of the body. The
patient's general physical health was fairly good. She frequently
complained of headache, and when she was exceedingly irritable
and violent all the athetoid movements would be intensified.
Speech was jerky and disordered, which gave it a distinctive
character. The special senses seemed to be unimpaired, and the
pupils were normal, except when an epileptic attack came on.
Death occurred in January, 1895, after an obstinate attack of
status epilepticus." Paramyoclonus multiplex is a condition of
chronic muscular spasm affecting the trunk, occasionally the
muscles of the face, abdomen, or diaphragm.
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