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99
sit down in the middle of the road. Felt as if her legs wanted to
give way. The doctor called that day in the ordinary course of
events, and she complained to him particularly of giddiness.
Temperature normal. Felt sick the next day but not worse.
Nausea was sometimes worse when sitting still, sometimes when she
was up and about. Had an attack of abdominal pain for about an
hour that evening. No diplopia. Had occasional twitching of tha
left shoulder and right upper arm. She complained that her legs
felt funny. Restless. Could not sit still for long. The following
day she complained of sleeping very badly and a feeling of
excitement round the heart. Still complained of headache.
Stated that "All I want to do is to lie like this"—she was then
reclining with her arms resting on the arms of the chair. Said
"I lie like this for five minutes, then I have to get up again."'
Could not concentrate well when she was reading. Family noticed
that she was getting irritable over little things. A day or two
later she stated that she did not want to do anything, had a bad
headache, could not read and had to close eyes to rest them. Had
recurrence of abdominal pains. The eyes had a somewhat peculiar
appearance. The difficulty in walking lasted for three days.
Plexor plantar reflexes on left side, right side not obtained. No
ankle clonus. Knee jerks brisk. Patient had troubled dreams.
A few days after the onset she complained of a feeling of excitement
inside, which she described as like the anticipation of a treat when
a child. When sitting she wanted support as she felt she might
pitch forward on her face. As the illness progressed she was still
feeling giddy but improving. She found going upstairs a great
effort. There was definite twitching of the face and the patient
felt muddle headed. The highest temperature recorded was 99.4.
Recovery was complete.
Not seen in consultation.
Case No. 16.
F.19. Employed at Dye Works. Onset 16/5/24.
As illustrating the difficulty in diagnosis, the following case