The patient was a young man æt. 17. His father suffered from a form of “phobia,” and had feelings of fear and general trembling when left alone in the dark. The patient inherited this condition. He was addicted to alcohol and masturbation. In January, 1899, he received a slight blow on the left parieto-occipital region. There was a little bleeding from a slight wound, but considerable mental shock. Two days later convulsive seizures, tonic and clonic, set in, and recurred for eight days. During the intervals he had marked hemicrania. He was sent to hospital in great fear of an operation. The convulsions ceased without treatment at once, but the hemicrania continued. In July he began to experience stiffness in the hands, with a feeling of resistance to any voluntary movement. This passed to the neck muscles, affecting first one side, then the other. On examination in October, he was found to have large, well-developed muscles. There was, however, diminished muscular power generally over limbs and body. The muscles of the upper limbs and neck reacted to mechanical stimulation applied directly or to the nerve-trunks. They responded to the faradic and galvanic currents to an exaggerated degree, and with greater duration than normal. The group chiefly affected on voluntary movement was the scalenes, the sterno-mastoid, and the trapezius. These passed into tonic contractions whenever the head was voluntarily rotated. These muscles were not so much affected when moved in other groups in different movements. The upper limbs were in a condition of “latent” myotonia.
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