666 THE ANIMAL PARASITES OF MAN 



symptoms and periods of complete sense of well-being ; in this way 

 a functional nervous affection may be simulated (Jolasse 1 ). Brim's 

 symptom (in the widest sense, sudden onset of violent cerebral 

 symptoms upon change of head-posture) is a specially characteristic 

 sign of free cysticercus in the fourth ventricle ; the disease generally 

 terminates with sudden death from cessation of the heart's action. 

 Defects in motor power, convulsions, implication of other nerves, 

 are rare and unessential complications (Hartmann 2 ). Carefully 

 carried out, lumbar puncture may possess some diagnostic and 

 therapeutic value. Treatment is purely symptomatic, or eventually 

 Neisser's ventricle puncture may be considered. 



At the base of the brain the cysticerci, as a rule, assume that 

 form which is designated as C. racemosus, and consists of rows of 

 delicate grape- like bladders in groups, sometimes also markedly 

 branched, but generally sterile, which develop in the meshes of the 

 soft meninges and may envelop the nerves and vessels of the base of 

 the brain. Such tumours bring about hydrocephalus and chronic 

 leptomeningitis, which must be regarded as the causes of the clinical 

 disturbances (cysticercus meningitis), attacks of loss of conscious- 

 ness, dementia and apathy, dulness and confusion and headaches. 

 In the case recorded by Meyer 3 symptoms which resembled paralysis 

 agitans were noteworthy, and defects in speech in the case recorded 

 by Durst 4 (C. racemosns in the region of the left Sylvian fossa). 

 According to Markwald 5 C. racemosns of the fourth ventricle is said 

 to represent a characteristic clinical picture : violent headaches, 

 attacks of vertigo followed very soon by deep coma and death 

 in a few days. Treatment in Cysticercus racemosns is ineffectual. 

 In the diagnosis of cerebral cysticerci in general the recognition of 

 multiple cysticerci in the skin and muscle and of the tapeworm is 

 of importance. In cases of cerebral diseases in which cysticerci may 

 be a possible cause, Remmert 6 recommends that the skin of the 

 whole body should be palpated. 



Cysticercus in the spinal cord and in the vertebral column is 

 occasionally observed ; as a rule, other organs, above all the brain 

 and its membranes, are simultaneously affected. Here, too, the 

 cysticercus occurs in two forms sometimes the cysts are roundish 

 or oval, solitary or multiple, and at other times Cysticercus racemosns 

 occurs. 



1 Jolasse, Munch, med. Wochenschr.> 1896. 



2 Hartmann, Wien. klin. Wochenschr., 1902. 



3 Meyer, Deutsch. med. IVochenschr., 1906. 4 Durst, Lieen, viestnik, 1902. 



5 Markwald, Munch, med. Wochenschr.^ 1895. 6 Remmert, "Dissert. Berlin," 1893. 



