ENDEMIC PARALYTIC VERTIGO 



1983 



' kubisagari,' which means ' he who hangs his head.' If the muscles 

 of the back are paralyzed, there may be difficulty in raising the 

 body from a stooping posture. Weakness in the hands, arms, and 

 legs is often observed, and is first noticed in the muscles connected 

 with symmetrical repeated movements. An attack lasts from ten 

 to fifteen minutes, and varies in severity, in mild cases there being 

 only ptosis and dimness of vision. Between the attacks the patient 

 is perfectly well in every respect. After severe attacks there may 

 be a little ptosis, or weakness of the muscles of the back, neck, hands, 

 or legs, and increased reflexes. 



Diagnosis. — -The characteristic symptoms are: Ptosis and the 

 falling forward of the head and neck. These symptoms differentiate 

 it f lom the other forms of vertigo. 



Prognosis. — The disease is never fatal, though it may last for 

 many years. 



Treatment. — The first requirement is removal from the endemic 

 area and from living in close proximity to stables. Medicines are 

 not of much use, but a combination of potassium iodide and arsenic 

 is recommended. 



LATAH. 



Synonyms. — Echomatism. Mimicismus, Sakitlatar, Jumping, Bah- 

 tschi, Myriakit, Meriatschenje. 



Definition. — Latah is a mental condition in which suggestion is 

 at once followed by uncontrollable action in the form of echolalia 

 or echokinesia, of which the mind is usually, but not always, 

 conscious. 



History. — The convulsive tics have been carefully studied in 

 Europe by Charcot, Gilles de la Tourette, and Guinon, but the 

 allied condition ' latah ' found in Malaysia, as well as similar con- 

 ditions found in other parts of the world, have as yet not been fully 

 investigated. Thanks to the labours of O'Brien in 1883, Gilmour 

 in 1892, Van Brero in 1895, Ellis in 1897, Gerrard in 1904, Manson 

 in 1907, Fletcher in 1908, Plan in 1911, and Abraham in 1912, 

 a fair amount of definite information with regard to latah is avail- 

 able. 



Climatology — Latah is found principally in the Malay Peninsula, 

 Java, Sumatra, and is also known in Siam, in Burma, in the 

 Philippines, Siberia, and among the Jumpers of North America. 

 Fletcher has rightly drawn attention to the fact that, while the 

 disease is very common in the Malay States, it is, apparently, rare 

 in the Malays who have emigrated. Thus, for example, it does not 

 occur among the large colony of Malays in Ceylon, which may be 

 due to the fact that they originally came from Batavia in Java, 

 and not from Malaya, but it is said by Fletcher to occur in Chinese, 

 Tamils, and in Europeans living in Malaya. The Ikota or Samoyeds, 

 and the Tigretier of Abyssinia, are said to suffer from similar symp- 

 toms. In children the disease is milder than in adults. 



iffitiology. — The exciting cause appears to be any sudden start, 



