Frank R. Ford

Many observers have, commented on the frequency of abnormalities of the thymus in patients with myasthenia gravis. Approximately one half of the reports of autopsies on patients with myasthenia gravis have contained descriptions of benign tumors, hyperplasia or persistence of the thymus. It is true, of course, that the autopsies on patients with myasthenia gravis are more apt to be reported if there is present some abnormality such as a tumor of the thymic region. On the other hand, it is likely that many small tumors or other abnormalities of the thymus have been overlooked at necropsy in a number of patients with myasthenia gravis. Norris 1 expressed the opinion that pathologic changes may be found in the thymus in cases of myasthenia gravis in direct ratio to the care with which they are sought. The literature contains the descriptions of only a few attempts to influence the course of

The contracture of the facial muscles and the tendency to mass movements of the face which so often follow Bell's palsy have attracted the attention of neurologists since the earliest times, and a great many theories have been offered to explain these phenomena. Sir William Gowers1was inclined to ascribe the mass movements to a change in the functional state of the nucleus, and Oppenheim, who evidently held similar views, spoke of irritation of the facial nucleus. In 1906 Lipschitz2offered a more satisfactory theory when he claimed that the mass movements were due to misdirection of regenerating nerve fibers. Spiller3pointed out in 1919 that the same explanation might be offered for facial contracture. Various writers have attempted to explain the syndrome of crocodile tears and the auriculotemporal syndrome on the basis of misdirection of regenerating nerve fibers, and certain phenomena which follow regeneration of the

CONTENTS Introduction. Infantile Hemiplegias Following Acute Infectious Diseases. Pertussis. Diphtheria. Other Acute Infectious Diseases. Infantile Hemiplegias in Apparently Healthy Children. Relation to Poliomyelitis. Relation to Epidemic Encephalitis. Relation to Miscellaneous Infections. Relation to Convulsions, etc. Material from Harriet Lane Home. Pathologic Anatomy of Infantile Hemiplegias. Hemiplegias Following Acute Infectious Diseases. Hemiplegias in Apparently Healthy Children. Conclusions. INTRODUCTION Hemiplegia in infancy is an unusual condition. Indeed, an analysis of the United States census report shows that the liability to hemiplegia in the first decade is less than one sixtieth of that in the seventh decade. Nevertheless, approximately seventy such hemiplegias are to be found in the records of the Harriet Lane Home among more than 50,000 case histories. Hemiplegia in adults is usually associated with hypertension, arteriosclerosis and syphilitic disease of the arteries. Hemiplegia in infancy results from very different factors. The acute hemiplegias of children usually occur under the age