Retrobulbar neuritis and facial palsy occurring in the same patient : with cases / by G. E. de Schweinitz.

  • De Schweinitz, G. E. (George Edmund), 1858-1938.
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: Retrobulbar neuritis and facial palsy occurring in the same patient : with cases / by G. E. de Schweinitz. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    teratives and electricity. A second attack of sclero-keratitis occurred in 1895 and was unassociated with facial palsy. The present attack did not differ from the others. Examination.—The girl is well formed, of good coloring, and with the exception of dysmenorrhea and ocular disturb- ances, in fair condition. The vision of the right eye was 6-60, and the eye contained the ordinary lesions of patchy opacity of the cornea following severe scleritis. In the left eye the vision was 6-5, the accommodation normal, the media clear, the optic disc was oi good color and the retinal circulation normal. The eye rapidly improved under treatment. About six weeks after her first visit, and without any spe- cial history of exposure to cold or draft, and with no ear disease, she appeared with right facial palsy, inability to close the eye or wrinkle the brow, etc., which never, however, be- came complete. There was gradual restoration of function, although the right side of the face continued to be rather stiff, with a good deal of twitching at the angle of the mouth. The patient was seen from time to time, but did not require special treatment until June 16, 1898, when she reappeared with the history that four days previous to her visit, after sleep- ing in a draft and when the night had become suddenly chilly, she awakened with a blur before the left eye, which rapidly developed until at the date of her visit she had only faint light perception in the peripheral field, the entire center of which was occupied by an absolute scotoma. The ophthalmoscope revealed moderate congestion of the disc. She was at once admitted to the Polyclinic Hospital and placed upon a treat- ment which consisted at various times of mercurial inunctions, pilocarpine sweats, iodide of sodium and counter-irritation. In two weeks vision was 3-60, excentric. The optic disc had lost its congestion, but there was decided pallor in the lower and outer quadrant and the ophthalmoscope revealed a large scotoma breaking through below. From that time until the present the condition has remained much the same, although the vision of the left eye has decidedlv improved, and at the last examination, 10, 24, 98, was 6-50 when the head was rotated slightly to the left. On August 9 I sent the patient to Dr. John H. W. Rhein, in order that he might examine the case electrically. He reports as follows: 1 find quantitative changes only, in slight degree, in the muscles of the affected side of the face, reaction of degeneration cannot be obtained, and the nerve transmits the currents well, though not so well as on the unaffected side. A careful application of galvanism to the face improved its appearance; similar application to the eye was not followed by improvement. There were no signs of central nervous