GENERAL PARESIS. (Paretic dementia)

Categories: 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 characteri tic 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.