PARATHYROID GLANDS 



619 



appeared to become, as a rule, more marked. Several of the cases of 

 tetany with epilepsy exhibited signs (choked discs, paralyses, etc.) point- 

 ing to organic brain disorder. Three of the cases of epilepsy combined 

 with maternity tetany were observed in Vienna, a region in which tetany 

 is endemic. 



The question of the pathogenetic relationships of childhood tetany 

 (and of spasmophilia) to epilepsy has always interested clinicians and 

 has been discussed by both podiatrists and neurologists. In six cases 

 of epilepsy after childhood tetany, described by Redlich from his own 

 experience and from the literature, the age of the persons at the time of 

 the observation was three, nine, ten, fourteen, twenty-three, and twenty- 

 four years respectively; but the epilepsy had existed in all of them from 

 childhood on; in part of 

 them it dated from the suck- 

 ling period. There was no 

 history of epilepsy in the 

 family of any one of these 

 six patients, though in one 

 case the child had suffered 

 from congenital lues and in 

 several of the cases there 

 were evidences of constitu- 

 tional inferiority of one 

 sort or another (idiocy, 

 hydrocephalus, marked 

 obesity, infantile myx- 

 edema, mongolism). 

 Enamel defects in the teeth 

 were observable among these 

 children. Chvostek's phe- 

 nomenon was present in them, too, but Redlich asserts that it is often 

 present (independent of tetany ?) in epilepsy and in other nervous diseases 

 .(including dementia precox, hysteria, neurasthenia, and Graves' disease). 

 Chvostek's phenomenon is known to be very common in children and to 

 grow less frequent in later life. Though Redlich admits that mild tetany 

 may be mueh more common in childhood than is generally thought, he is 

 unwilling to go so far as to assume that the presence of a Chvostek sign 

 necessarily means the existence of tetany. 



Under spasmophilia, or the spasmophile diathesis of Finkelstein, 

 Thiemich included tetany, laryngospasm (which in most cases belongs to 

 tetany), and, finally, eclampsia infantum. He, however, separated the 

 latter from epilepsy, despite its resemblance to epileptic attacks. He 

 believed that eclampsia infantum can be separated from true epilepsy 

 through the circumstance that, in the former, spasmophile phenomena 



Fig. 9. Trophic disturbances (dystrophy) of 

 the teeth in a case of chronic recurrent tetany 

 with no traces of rachitic bone changes. Note the 

 parallel grooves due to enamel defects. (After E. 

 Phleps, in Lewandowsky's Handb. d. Neurol., pub- 

 lished by J. Springer, Berlin.) 



