-
- In Dr Brown Séquard's work on the
"Physiology of the Nervous system" are some
interesting observations on the parts of the
nervous system having to do with
respiration.
-
- He writes: "In man, haemorrhage in the
various parts of the bases of the encephalon,
near the median line or upon it, produces
trouble in respiration, which is more and more
marked the greater the amount of effused blood
and the nearer it is to the medulla oblongata.
Certainly, in many cases, the trouble of
respiration may be partly attributed to pressure
on the medulla oblongata, but it is not always
so; and, at any rate, in several cases of
softening of the pons Varolii, in which it
cannot be said that there was a pressure on the
oblong medulla, there has been a trouble of
respiration. From the examination of a great
many cases, I have been led to the conclusion
that the whole base of the encephalon is
employed in respiration".
-
- Hence we understand why the patients whose
cases have been just related (Chas R. and Joseph
B.) should suffer from certain defects of
respiration referred to the narration of their
cases - the gaping in one and the coughing in
the other, attended by the involuntary throwing
out of the paralysed arm and leg, so that they
became quite stiff on that side. The patient
Joseph B., said that ever since the attack ha
has suffered from what he calls asthma, and
before the actual attack he had considerable
respiratory trouble.
-
- As is recorded by Dr J.W. Ogle in the ninth
volume of the Pathological Society's
transactions, in which there were similar
symptoms. It was not, however, a case of disease
of the pons, but hemiplegia from cancerous
disease on the surface of the opposite
hemispheres. The case altogether is full of
interest, but the following quotation from Dr
Ogle's record bears most on our present
subject:
-
- "A very remarkable phenomenon during life
was the forcible clenching of the paralysed hand
during yawning, which would immediately
drop after the yawning; as also the
involontary muscular motion of the paralysed arm
observed when the patient was about to come to
the Hospital, and was thereby agitated in the
mind. The former of these facts is comparable to
the first mentioned by Abercrombie,
of a rising up of the paralytic arm in
hemiplegia, at each time of yawning. In a
letter to the late Mr. Shaw, that physician
describes the case of a man who had not the
least power of motion of the left side, except
underthe following circumstances:
-
- "He was very much affected by
yawning, and every time he yawned
the paralytic arm raised up, with a firm, staedy
motion, until it was at right angles with his
body, as he lay in bed. The arm was raised
steadily durins inspiration, and, when the
expiration began, seemed to drop by its own
weight, with considerable force. He continued
liable to this affection for a considerable
time, and it ceased gradually, and he began to
recover the natural motion of the limb".
-
- "This case," Dr Ogle continues, "Bell
adduces, as showing how independant the
automatic respiratory acts are of the volitional
ones, and, as coinciding with the movements of
the muscles of the face, shoulders,
sterno-mastoid, trapezius, etc., which occur in
hemiplegia, through the agency of those nerves
which control and combine the muscles in
respiration. It is interesting to notice the
coincidence of the arm movements in
respiration." Dr Ogle adds in a note: "Since the
above was written, we have had, in St George's
Hospital, a man affected with incomplete
hemiplegia, whose paralysed arm shook vehemently
on any emotion being experienced, and whose
flexed and paraysed fingers were extended
involuntary whenever he yawned".
-
-
- Why
a paralysed arm raises during
yawning?
-
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Gendrin A Des maladies de l'encéphale
et de la moelle épinière
Germer-Baillière 1835
- Abercrombie
J Yawning and apoplexy Medical Times and
Gazette 1863;1:656-661
- Bauer G. et al
Involuntary motor phenomena in the locked in
syndrome J Neurology 1980;223;:91-198
- Bertolotti M.
Etude sur la pandiculation automatique des
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1905;2(19): 953-959
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O, Azulay JP, Serratrice G. A single report
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- Brissaud E,
Pinard, A, Reclus P Pratique
médico-chirurgicale
Hémiplégie par A Souques Masson
1907, p538-539
- Brissaud E
Leçons sur les maladies nerveuses Masson
1895, p458
- Darwin E.
Zoonomia 1801
- de
Buck Classification des mouvements anormaux
associés à
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1899;6:361-365
- Furtado D.
Provocation spinale d'un réflexe de
bâillement. Rev d'oto neuro
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J., Bogousslavsky J. Dissociated
preservation of automatic-voluntary jaw
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2003;50:185-188
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Yawning and associated phenomena Physiological
Review 1946;25:156-168
- Klippel M et
Monier-Vinard R. Hémiplégie
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Médecine. Masson. 1928 p 316
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observation de bâillement convulsif
périodique Le Courrier Médical
1879;29;334-336
- Liégey
Deux observations de bâillements
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J. Le diagnostic des maladies nerveuses
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