Plate 30-31

Plate 30-31 Plate 30-31

Head posture, mouth movement and miming from sclerosis multiplex cerebrospinalis.

The four pictures are recorded back to back while the patient spoke. The first picture shows how the patient began to speak with quavering lower lip drawn down, slightly furrowed brow and eyebrows somewhat pulled together. In the second picture one sees the mouth open wider still, the right corner of the mouth convulsive, pulled up, the brow still more pleated. The third picture shows the state of greatest strain in the peripheral organs of speech from maximum partaking of the mime. At the moment in question, both rows of teeth are proximal to each other, freely visible except for a narrow crack, upper and lower lips appear convulsively swung, the eyebrows are pulled ad maximum in height, the head is completely hoisted and somewhat circumflex towards the back. The fourth picture shows the patient satisfied at accomplishing the difficult feat.

The 38 year old patient, prior steward, misplaced the onset of his ailment 5-6 years before. He also gave in the aggregate the typical image of the disease of disseminating common sclerose:   intention tremors , spastic paretic gait and escalation of tenon reflex, short lasting apoplexy type attacks, nystagmus. Incremental dementia. Bladder and rectum were untroubled, the sensibilities in no respect impaired.

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