Identifier: treatiseonner00sach (find matches)
Title: A treatise on the nervous diseases of children, for physicians and students
Year: 1905 (1900s)
Authors: Sachs, Bernard, 1858-1944
Subjects: Nervous system Children
Publisher: New York, W. Wood and company
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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nd in severalcases I have observed that the lower and middle musclescould be contracted only if the attempt was made to closethe eyes (Fig. 55). Sensory disturbances are entirely absent, as the facialnerve is a purely motor nerve, the sensory fibres of the face * A few cases of double facial palsy have been reported (Mott, Huebschman); a suc-cessive involvement of the two sides is more frequent. The author has observed it incases associated with diabetes in the adult. 218 THE NERVOUS DISEASES OF CHILDREN. coming from the fifth nerve. I have seen a few cases ofsevere neuralgic pains complicating facial palsy in children,but to account for it there has always been some additionalcause, as in a boy of fourteen, whom I recently examined,in whom decayed upper teeth offered the explanation forthe neuralgic supraorbital pain. Whatever part of the nerve is involved, provided it bebetween the nucleus of the facial nerve in the pons andthe periphery, electrical changes will be found. In all but
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Fig. 55—Boy with Facial Palsy, in Stage of Recovery. Slight contracture of para-lyzed side (B) ; in figure A mouth is pulled to the paralyzed side when boy attemptsforcibly to close left eye ; also deepening of naso-labial fold. the very mildest cases the faradic response of the nerveas well as of the muscles is lost. My own experience hasproved, however, that there is an exception to this rule, andthat is, that if the patient be examined within the first forty-eight or seventy-two hours after the onset of the palsy, thefaradic response may still be present; it rapidly diminishes,however, and after a period of three days, in the vast ma-jority of cases, it is entirely lost. The galvanic responseof the nerve may be increased during the first few days,but it is soon diminished or lost. The galvanic irritabilityof the muscles supplied by the facial nerve shows many in-teresting changes. In the earlier stages of the disease, and DISEASES OF THE PERIPHERAL NERVES. 219 in all but the seve

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