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GENERAL PARESIS. (Paretic dementia)

Category: Diseases of The Nervous System

This belongs under diseases of the mind, but
there are so many cases that a description of this disease may be
instructive and interesting. One author says: "General paresis is a
chronic, progressive, diffuse, encephalitis (inflammation of the brain),
resulting in structural changes in the cerebral (brain) tissue, with
involvement of the cortical, and meningeal, (covering) blood and lymph
vessels, presenting characteristic symptoms, with progressive course and
fatal termination usually within three years." There are three stages:--1.
The period of incubation (the prodromal stage). 2. A stage of pronounced
mono-maniac activity with symptoms of paralysis. 3. Stage of extreme
enfeeblement with diminution and final loss of power. These stages run
into each other. First stage in a typical case:--There are tremblings and
slight trouble in speech and expression of the face. The mind has exalted
and excited spells, etc.

Symptoms. The patient is irritable. The mental and moral character is
unstable. His affairs are in confusion. He uses bad language, neglects his
family, goes with drunkards and bad women, makes indecent proposals to
respectable women of his acquaintance without realizing that it is
improper. He cannot keep his mind on one thing. Speech is a little thick,
indistinct and hesitating. Syllables are dropped or repeated, speech
finally becomes undistinguishable. He is very excited; he thinks he is
persecuted. He is a big fellow generally. He is a king, he is rich and
mighty. This is the usual run. As the disease progresses he becomes
feeble-minded more and more so continually. Persistent insomnia comes on
early and frequently recurring, one-sided headache often goes with it.
Sometimes there is an uncontrollable desire to sleep. Loss of
consciousness is an early symptom. After severe attacks there may be
one-sided paralysis (hemiplegia) which usually disappears in a few hours
or days. Convulsions like epilepsy may appear early, but usually occur in
the later stages. The pupils are mostly dilated, rarely contracted, and
they are often unequal and react slowly to light. When the tongue is
protruded it trembles and is put out in a jerky manner. The hands tremble,
in the advanced stage. The speech is jerky and slow. Syllables are dropped
and repeated. One early symptom is retention of the urine. There is
another annoying symptom--a constant grinding of the teeth. The walk is
very spasmodic, but in advanced stages it becomes slouching or dragging.
The skin may be red or blue. When the feeble-mindedness is fully developed
the mind does not perceive anything accurately. He sees imaginary things,
and things that he does see do not appear to him as they are. Finally he
has no mind.

Treatment. The end is sure. You can relieve the distress partly. Personal
attention by a physician is needed.



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