Neurological sequelae of captivity (1946)

nutritional polyneuritis often called very berry was commonly found these photographs show extreme wasting of the intrinsic muscles of the hands with claw contracture and dropped wrist the legs show foot drop wasting of all muscle groups below the knee especially the anterior group and loss of tendon reflexes this patient has lost all sensation below the inguinal ligament this man has made a good recovery on oral vitamin b1 therapy and now walks with only a slight steppage gate this man is recovering from a sensory ataxia captivity chord syndrome is the name applied to cases who show dysfunction of the long track of the spinal cord the posterior columns are most frequently involved these shots show gross sensory atxia of the lower limbs appreciation of light touch and thin prick is only slightly impaired at the periphery of the lymph provided that the condition is not initially too severe such cases make a good recovery aided by re-educational exercises in a walking chair this man who was too unsteady to be able to stand on arrival is now making progress with the help of an improvised walking chair the worst cases show sensory atexia of the upper limbs also and the finger nose test is very inadequately performed buying movements such as undoing and fastening buttons can only be carried out with great difficulty such a taxi is accentuated when the eyes are shut joint and vibration sense are lost often below the mid dorsal region the patient will lift his hand whenever he feels vibration this patient has lost vibration since below the eighth dorsal segment this patient has lost vibration since below the tenth dorsal segment light touch and pinprick are retained except in some cases where a coexistent beriberi causes some peripheral sensory loss the tendon reflexes in the affected limb are usually lost lesions of the pyramidal tracts causing spasticity are only rarely encountered this patient has exaggeration of all tendon reflexes and a sustained ankle clonus however as there is also peripheral neuritis causing foot drop the hallux cannot extend cranial nerve involvement also occurs this case has paresthesia over the distribution of the trigeminal nerve with insensitive cornea nerve deafness is fairly common this patient can only hear words shouted into his ear you