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PERNICIOUS ANEMIA AND COMBINED SYSTEM DISEASE WITH DIABETES MELLITUS AND PARKINSONIAN SYNDROME: Report of a Case

PERNICIOUS ANEMIA AND COMBINED SYSTEM DISEASE WITH DIABETES MELLITUS AND PARKINSONIAN SYNDROME:... Abstract This case is reported because of its uniqueness and because of the emphasis laid on an important principle in the economy of the nervous system. That is, when the balance between two opposing systems is interfered with by disease, the clinical picture is so modified that it may lose one or several of its characteristic qualities. In this case a parkinsonian syndrome occurred without rigidity of muscles and without the characteristic masklike facies. The presence of lesions in the posterior column as a result of pernicious anemia so decreased the tonic qualities of the neuromuscular system that although a lesion was postulated in the striate system no rigidity was found and the muscles were hypotonic. From the series reported by Ahrens,1 Weil,2 Wilkinson3 and Woltman4 and the recent article by Goldhamer, Bethell, Isaacs and Sturgis,5 it is agreed that about 80 to 90 per cent References 1. Ahrens, Richard: Neurologic Aspects of Primary Anemia , Arch. Neurol. & Psychiat. 28:92 ( (July) ) 1932. 2. Weil, Arthur, and Davison, Charles: Changes in the Spinal Cord in Anemia: A Clinicomicroscopic Study , Arch. Neurol. & Psychiat. 22:966 ( (Nov.) ) 1929. 3. Wilkinson, John F.: Diseases Associated with Pernicious Anemia , Quart. J. Med. 2:281, 1933. 4. Woltman, H. W.: The Nervous Symptoms in Pernicious Anemia: An Analysis of One Hundred and Fifty Cases , Am. J. M. Sc. 157:400, 1919. 5. Goldhamer, S. M.; Bethell, F. H., Isaacs, Raphael, and Sturgis, Cyrus C.: The Occurrence and Treatment of Neurologic Changes in Pernicious Anemia , J. A. M. A. 103:1663 ( (Dec. 1) ) 1934. 6. Barrett, A. M.: Mental Disorders of Pernicious Anemia , Am. J. Insan. 69:1063, 1913. 7. Woltman, H. W.: Brain Changes and Pernicious Anemia , Arch. Int. Med. 21:791 ( (June) ) 1918. 8. Root, Howard F.: New Cases of Combined Pernicious Anemia and Diabetes , New England J. Med. 208:819 ( (April 20) ) 1933. 9. Paviot, J., and Dechaume, J.: Considérations sur un syndrome neuroanémique avec lésions diencéphaliques, chez une tuberculeuse pulmonaire non évolutive , Bull. Acad. de méd. , Paris 109:102, 1933. 10. Castle, W. B., and Weiss, Soma: Personal communication to the author. 11. Lederle's solution of liver extract was used. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology & Psychiatry American Medical Association

PERNICIOUS ANEMIA AND COMBINED SYSTEM DISEASE WITH DIABETES MELLITUS AND PARKINSONIAN SYNDROME: Report of a Case

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Publisher
American Medical Association
Copyright
Copyright © 1936 American Medical Association. All Rights Reserved.
ISSN
0096-6754
DOI
10.1001/archneurpsyc.1936.02260010136011
Publisher site
See Article on Publisher Site

Abstract

Abstract This case is reported because of its uniqueness and because of the emphasis laid on an important principle in the economy of the nervous system. That is, when the balance between two opposing systems is interfered with by disease, the clinical picture is so modified that it may lose one or several of its characteristic qualities. In this case a parkinsonian syndrome occurred without rigidity of muscles and without the characteristic masklike facies. The presence of lesions in the posterior column as a result of pernicious anemia so decreased the tonic qualities of the neuromuscular system that although a lesion was postulated in the striate system no rigidity was found and the muscles were hypotonic. From the series reported by Ahrens,1 Weil,2 Wilkinson3 and Woltman4 and the recent article by Goldhamer, Bethell, Isaacs and Sturgis,5 it is agreed that about 80 to 90 per cent References 1. Ahrens, Richard: Neurologic Aspects of Primary Anemia , Arch. Neurol. & Psychiat. 28:92 ( (July) ) 1932. 2. Weil, Arthur, and Davison, Charles: Changes in the Spinal Cord in Anemia: A Clinicomicroscopic Study , Arch. Neurol. & Psychiat. 22:966 ( (Nov.) ) 1929. 3. Wilkinson, John F.: Diseases Associated with Pernicious Anemia , Quart. J. Med. 2:281, 1933. 4. Woltman, H. W.: The Nervous Symptoms in Pernicious Anemia: An Analysis of One Hundred and Fifty Cases , Am. J. M. Sc. 157:400, 1919. 5. Goldhamer, S. M.; Bethell, F. H., Isaacs, Raphael, and Sturgis, Cyrus C.: The Occurrence and Treatment of Neurologic Changes in Pernicious Anemia , J. A. M. A. 103:1663 ( (Dec. 1) ) 1934. 6. Barrett, A. M.: Mental Disorders of Pernicious Anemia , Am. J. Insan. 69:1063, 1913. 7. Woltman, H. W.: Brain Changes and Pernicious Anemia , Arch. Int. Med. 21:791 ( (June) ) 1918. 8. Root, Howard F.: New Cases of Combined Pernicious Anemia and Diabetes , New England J. Med. 208:819 ( (April 20) ) 1933. 9. Paviot, J., and Dechaume, J.: Considérations sur un syndrome neuroanémique avec lésions diencéphaliques, chez une tuberculeuse pulmonaire non évolutive , Bull. Acad. de méd. , Paris 109:102, 1933. 10. Castle, W. B., and Weiss, Soma: Personal communication to the author. 11. Lederle's solution of liver extract was used.

Journal

Archives of Neurology & PsychiatryAmerican Medical Association

Published: Jan 1, 1936

References