Injuries of nerves and their consequences - Reflex Sympathetic ...

368 INJURIES OF NERVES.
I think that it would be justifiable in these cases to
divide the nerves concerned in the motions; but I should
feel cautious and anxious about any such operation,
having seen two instances in which operations for other
causes proved fatal in adult chorea.
Choreal spasyns iviih neuralgia.
— There are also examples
of chorea in stumps associated with intense pain, and it
is not uncommon to find that in certain persons the rare
spasmodic movements of stump muscles are accompanied
by neuralgic paroxysms, just as happens in certain facial
tics, and more rarely in such instances of general neuralgia
as I have described elsewhere.*
A distressing example of this combination is related
The forearm of a woman was re-
by Mr. Langstatflf
moved on account of neuralgia from injury, and, healing
with difficultv, there ensued a constant state of convulsive
action in the stump muscles with agonizing pain.
A great variety of treatment failed to relieve her. The
skin over the bones was red and sore, the arteries beat
with extreme violence, frequent convulsive fits followed,
and her general health gave way. The limb was finally
reamputated above the elbow, when the nerves were
found to be greatly enlarged and to end in the stump in
the usual button-like growths. Entire and continued
relief was obtained by the operation.
* Keports of Philadelphia College of Physicians, 1869,
\ Med.-Chir. Trans., v. xvi. p. 140.