14 



G. H. MONRAD-KROHN. 



M.-N. Kl. 



Sometimes one finds the branches of the trigeminal area distinctly 

 thickened. This is most easily noticed in the frontal and supraorbital 

 nerves. Fig. 3 shows a visible thickening of the left supraorbital nerve. 

 As has already been pointed out in the previous chapter, in the maculo- 

 anæsthetic form attacks of neuralgis pains often occur, accompanied by an 

 acute swelling up of the corresponding nerves. (Cpr. Fig. 3).' 



The seventh cranical nerve (the facial nerve) is also afifected in a great 

 number of cases, and this affection is very characteristic of leprosy. 



The following table gives the result 

 as regards the function of the facial nerve 

 in a series of 59 cases. 



It will be seen from this table that 

 facial paralysis occurs in the nodular as 

 well as in the maculo-anæsthetic form. 



It will further be seen that the facial 

 paralysis has a number of characteristic 

 features, which distinguish it from other 

 kinds of facial paral^-sis — central or 

 peripheral. 



The following points which may be 

 gathered from my observations are per- 

 haps the most important 

 I. The upper part of the face — par- 

 ticularly the orbicularis oculi^ and 

 the corrugator — is more often and 

 more intensely affected than the lower 

 part of the face, 

 this paralysis of the upper part of the face is as a rule bilateral, 

 in the inferior part of the face the supraoral muscles are more com- 

 monly affected than the infraoral muscles, 



this paralysis in the inferior part of the face is not so constantly bi- 

 lateral as the paralysis in the upper part of the face, 

 the paralysis is accompanied by extreme hypotonia or atonia, which 

 causes ectropion of the eyes in a great mumber of cases — and in some 

 cases where the orbicularis oris is equally affected, "ectropion of the 

 mouth". This is generally accompanied by dribbling of saliva from 

 the mouth. 



Fig. 3. Photograph of case Nr. 2 (I. H.) 

 SweUing of left supraorbital nerve. 

 Case of Dr. H. P. Lie. Cpr. Pro- 

 ceedings of II International Leprosy 

 Conference in Bergen 1909. (The 

 swelling has disappeared since.) 



' This might also be seen in the course of treatment with nastin, and fig. 3 is in fact 



a photograph of a patient of Dr. H. P. Lie, where the swelling of the left supraorbital 



nerve occurred during such treatment. 

 2 It should in this connection be mentioned that Kondriavsky (Thèse de Saint-Pétersbourg 



1896) regards weakness of the lower eyehds as an initial and characteristic sign of 



leprosy. 



