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I may say, however, that I have some data already at hand in which certain types of epileptic phenomena connected with infantile cerebral hemiplegia would show that the so-called epileptic constitution is much less marked in these cases, but is present, however, to a certain degree.
Although repeatedly questioned, he could recollect no other circumstance which he could consider as having been likely to have occasioned his malady. He had not suffered much from Rheumatism, or been subject to pains of the head, or had ever experienced any sudden seizure which could be referred to apoplexy or hemiplegia.
He exhibited signs of hemiplegia on the right side, but these soon disappeared and he became subject to periodic attacks lasting from twenty-four to forty-eight hours, during which he was a mere automaton. In these attacks he walked continually, incessantly moving his jaw, but not uttering a word. He was insensible to pain, electric shock, or pin-prick.
"Your experience, Sir Baldwin, will enable you readily to diagnose my symptoms. Owing to the passage of a bullet along a portion of the third left frontal into the postero-parietal convolution upon which, from its lodgment in the skull, it continues to press hemiplegia of the right side has supervened. Aphasia is present also...." The effort of speech was ghastly.
There is paralysis and insensibility of the right side, and, as is often the case in right hemiplegia, the speech is indistinct and difficult. Nevertheless he is constantly haranguing any one who will listen to him, abusing his physicians, or preaching with a monkey-like impudence rather than with reasoned clearness radicalism in politics and atheism in religion.
Hæmorrhage into the pons may give rise to contracted pupils. Young children and infants are specially susceptible to the poison. Diagnosis is not always easy, and one has to differentiate poisoning from cerebral apoplexy. In the latter one can seldom rouse the patient, the pupils are often unequal, and hemiplegia is present.
Most skilful surgeons are misled by its cunning into believing and pronouncing able-bodied young women to be victims of spinal disease, "stricture of the oesophagus," "gastrodynia," "paraplegia," "hemiplegia," and hundreds of other affections, with longer or shorter names.
It was a case of hemiplegia, which had paralysed the whole of his right side, his right leg and right arm, and had also spread to his face in such wise that he could no longer speak. The only sound he could raise was an incomprehensible guttural grunt.
The most remarkable feature was the loss of all memory of his life for twenty years before the accident. As time went on, the period included in this loss of memory was reduced to five years preceding the accident. The hemiplegia persisted, although the man was able to get about.
Lady Mary sat beside the bed with clasped hands, praying dumbly, with her eyes fixed on her grandmother's altered face. Mr. Horton came, as soon as his stout mountain pony could bring him. He did not seem surprised at her ladyship's condition, and accepted the situation with professional calmness. 'A marked case of hemiplegia, he said, when he had observed the symptoms.