Brachial monoplegia, tetanic.
Case 409. (Routier, 1915.)
A soldier sustained a penetrating wound of the back of the thorax on the left side and received an injection of antitetanic serum. A few days later, May 18, 1915, he came on hospital service very sick, with high temperature and marked suppuration. The next day he had an anxious facies, temperature of 40 degrees, and sharp pains in the left arm. This arm May 21 was still very painful and then began to make involuntary movements in the shape of incessant clonic contractions. The forearm would suddenly flex upon the upper arm, and the upper arm itself would violently push itself forward and outward. Meantime, the wrist and fingers were not involved in the contractions. The movements were continuous, but paroxysmally increased in extent.
Babinski, called in consultation, confirmed the diagnosis of an anomalous form of tetanus. Next day trismus, pleurosthotonos, and stiff neck developed. Antitetanic serum and chloral had been given from the beginning, with morphine at night. The patient, however, died with asphyxia June 3.
Re brachial monoplegia, the hysterotraumatic form first observed by Charcot has an anesthesia with the shoulder of mutton distribution, slightly affecting the thorax in front and behind, in addition to the paralysis.