ATHETOSIS OF THE FACE. 209 



the eye is sufficiently open to allow of the pupil 

 being distinctly seen (coincident action of the 

 orbicularis and levator palpebrse ?). 



The eyes are much moved in a restless manner, 

 and are frequently turned upwards when the 

 eyelids are being closed. There is never any stra- 

 bismus. Fundus oculi normal. The tongue is 

 protruded at request, and kept out, and there is 

 much irregular movement of its muscular structure. 



As the patient stands upright with his heels 

 together, there is scarcely any movement of the 

 body. When he holds out his hands, and spreads his 

 fingers, they are kept steady, but very slight abductor 

 movements and almost inappreciable flexor- extensor 

 movements of the fingers are seen ; there are also 

 slight movements of the toes. He walks well, with 

 a steady gait, but slight irregular swaying move- 

 ment of the head. 



His heart and lungs appeared normal, 



The following was the history of the case : He 

 had always been strong and well till a year and a 

 half or two years previous to my seeing him. He 

 never had convulsions ; he went to school when 

 five years old, was bright and intelligent, and did 

 as well as other boys till the autumn of 1876 ; 

 never any complaint of pain till this time. About 

 that date it was noticed that he made contortions 

 of his face, and frequently nodded his head ; then, 

 later on, the fingers of the right hand began to 

 work. After some months.it was noticed that his 

 manner was changed; he became forgetful and 

 vacant at times as if silly. 



p 



