WeRead Powered by ReaderPub
Shell-shock and other neuropsychiatric problems cover

Shell-shock and other neuropsychiatric problems

Chapter 255: Case 230. (Roussy and Lhermitte, 1917.)
Open in WeRead

About This Book

The work assembles nearly six hundred clinical case histories drawn from wartime medical literature to document combat-related neuropsychiatric disorders. It presents concise case protocols illustrating varied symptom patterns, diagnostic dilemmas, malingering and simulation, therapeutic interventions, and treatment outcomes, and includes bibliographic references and introductory commentary. Sections juxtapose cases to illuminate contested diagnoses and to inform postwar rehabilitation and mental-hygiene efforts, aiming to provide clinicians and reconstruction workers with detailed clinical material for recognizing, classifying, and managing neuropsychiatric consequences of war.

Wound of thigh: Pseudocoxalgic monoplegia with anesthesia. Cure of anesthesia by faradism at one sitting. Cure of lameness by reëducation and electricity in one month.

Case 230. (Roussy and Lhermitte, 1917.)

An infantryman, observed at Villejuif, February 9, 1915, was suffering from a right-sided crural monoplegia of a pseudocoxalgic type, following a wound September 9, 1914. The wound had been a through-and-through one in the upper right thigh. Every active movement could be performed as well on the right side as on the left; but the strength of the movements was less on the right, especially that of leg-extension. The reflexes were normal, the lameness was slight, with toeing out; the sole came down flat upon the ground. There was an absolutely complete anesthesia of the entire right leg and side up to the umbilicus.

Energetic faradization of the skin caused the anesthesia to disappear the day the patient was brought to the hospital. The cure of the lameness required a month of reëducation and electricity.

According to Roussy and Lhermitte, crural monoplegia is less frequent than brachial monoplegia. The flaccid form is rare, and when it occurs, complete, though the patient always remains capable of executing some voluntary movements and can walk with crutches or cane. During the automatic movements of walking, some muscles may be observed to contract that remain immobile when the patient is being examined recumbent. Naturally such a difference in contractions standing and lying, would be very exceptional in a case of organic monoplegia.