INVOLUNTARY MOVEMENTS OF THE FACE. 211 



Hemiplegia : involuntary movements of arm and 

 face. 



Arthur T , aged ten years, came under my 



observation (May, 1880) as the subject of a chronic 

 left hemiplegic affection. His general health had 

 been good. His left upper extremity was wanting 

 in muscular voluntary power and in muscular sense ; 

 certain involuntary movements of the hands and of 

 the fingers were also observed. I now collect the 

 notes describing the nerve-muscular condition of 

 the hand. The left hand, when held out, assumed 

 on the average the " nervous position ; " not so the 

 right, which was natural. A certain amount of 

 involuntary movement of the fingers was seen ; the 

 middle finger moved the most ; during the examina- 

 tion, and at other times when his fingers were 

 curling up against his will, he would frequently 

 use the right hand to strengthen the fingers of 

 the left. As to the kind of movement, it certainly 

 was not voluntary, and on several occasions a 

 similar movement was seen repeated. The dyna- 

 mometer showed the power of the right hand as 47, 

 against 36 '5 on the left side. 



I had often noticed that the boy looked much 

 distressed when I examined the left arm, and this 

 appeared not surprising, considering that, with good 

 bodily health, he was losing the use of the left arm, 

 and at the same time there was family trouble from 

 the father being out of work. Looking at the 

 lad's face, one observed distinct over-muscular 

 action in the upper zone, causing in the middle 



