150 years ago: Hysterical paraplegia in a patient suffering from epileptic mania. December 2019;263(1832):30

150 years ago: Hysterical paraplegia in a patient suffering from epileptic mania

20 Dec 2019

AUTHORS

Written 150 years ago by Edward Swain, M.R.C.S.

Article

E.S, A GIRL OF 16 YEARS of age, suffering from epileptic mania, and never having menstruated, was admitted into the Brookwood Asylum in October 1868, being unable to use either of her legs, and having in consequence to be carried into the ward on her arrival.

Medicine was given to her to open her bowels, and, as she was very restless, a single dose of 20 minims of the liquor opii was administered: this produced sleep. She was anaemic, and generally weakly in appearance. She was both wet and dirty in her personal habits, but whether this was due to the same cause as the paralysis, or to her mental disease, it is not possible to say.

Electo-magnetic therapy

A few days after her admission the use of Browning’s electro-magnetic machine was commenced, and was persevered in daily until her entire recovery. It was first tried by her taking hold of the handles: this produced no effect. The handles were then placed to her feet, but for about six days she did not feel any current at all. At the end of that time, however, she experienced a tingling sensation: the machine was used alternately to the feet, hips, and knees.

 Gradual recovery

About the end of December she was enabled to crawl about, and employ herself a little in cleaning the floors of the infirmary in which she was placed. She gradually improved, and during the second week in March she had her first catamenial period.

In the beginning of April she suddenly discarded her crutches, which she had used for two or three months; and at the ball given to the patients the following week, danced several times, appearing to have quite recovered both sensation and motion. It is needless to say she was much tired after dancing. The epilepsy continued, with occasional attacks of excitement, until December, when she was discharged as recovered. She has since been a patient in the asylum, suffering from the same form of mental disease, but having exhibited no recurrence of loss of power over her limbs.

It would appear that recovery was not, in this case, due to the appearance of the catamenia, as before that period there had been gradual improvement; and the actual ability to use the legs properly did not occur until three weeks after the menstrual period; therefore, one is led to think that the electro-magnetism must have exerted a decidedly beneficial effect.

The dirty habits continued only a short time after a certain amount of sensation had returned to the limbs.