Stretching of the facial nerve for the relief of spasm of the facial muscles / by W. Allen Sturge and Rickman J. Godlee.

  • Sturge, William Allen, 1850-1919.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Stretching of the facial nerve for the relief of spasm of the facial muscles / by W. Allen Sturge and Rickman J. Godlee. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Now, the rationale of nerve stretching must be sought for in the profound shock produced on the nervous system by the operation, and this shock may be supposed to act on (1.) The nerve fibres themselves. (2.) The centre from which the fibres take their im- mediate origin. (8.) The higher centres to which the nerve passes after leaving the centre just named; the effects of the shock ultimately making their way to the cortical centres them- selves. It is perfectly evident that the parts which will suffer most will be the fibres of the stretched nerve and the nerve cells from which they take their immediate origin. The cells in the higher centres will be less and less affected in proportion as they are farther and farther removed from the nerve trunk, the cortical being affected least of all. From this it would follow that those varieties of spasm which depend upon a lesion of the lowest centres, as shown by the simplicity of the spasm and the complete absence of any attempt at coordinated movement, are more likely to be influenced by nerve stretching than those which, by their complexity and coordination, point to a lesion of one of the higher centres. I think therefore that in examining cases of spasmodic action of muscles, with a view to treating them by nerve stretch- ing, it will probably be found of the utmost importance, so far as prognosis is concerned, to examine carefully whether the spasm is confined to simple incoordinated contraction of the muscles supplied by one on more nerves, or whether it be a complex coordinated action allied to those seen in chorea, athetosis, or the condition termed hemi-kinesis. With a view to clearing up this point, I think it very important that all cases where nerve stretching has been employed without success should be reported, and that in all such cases an accurate description of the kind of movement present should be given, that we may be able to judge of the relative action of nerve stretching on the various forms of spasm. Report on the further progress of the case.—May 27,1881.— Since October last, when our paper was read, the success of the operation has been for the most part maintained. When last seen, about a week ago, the face was quite free from twitching, and the action of the muscles in ordinary move- ments of the face was almost equal on the two sides. Within