Case 398. (Cassirer, February, 1916.)

On March 9, 1915, a shell wounded a man slightly, and burned off some of the hair of his head. He was unconscious two days, and on waking vomited for a time. Shortly after the injury difficulties in standing and walking set in, with headache, noises in the left ear, difficulty in the intake of ideas, excitability, and poor memory. Then, slight improvement. About the middle of June he was no longer closely confined to bed and could take a few steps with two canes; but the gait was still unsteady and the left leg tended to make abnormal-looking movements. There was nystagmus, rapid, though constant, on looking to the left,—more in the left eye; and nystagmus on looking to the right,—more in the right eye. Adiadochokinesis absent. Vestibular nerve somewhat excitable. Deviation outward in finger-pointing test.

According to Cassirer, this case is one largely of psychogenic origin, with possibly an organic cerebellar nucleus. The knee-jerks absent (even up to March 31). W. R. negative.