A Case of Encephalitis Periaxialis

(1) Mental dullness?6 weeks. (2) Loss of hearing in both ears?6 weeks. (3) Loss of sight in both eyes?6 weeks. (4) Loss of speech?2 weeks. (5) Involuntary movements of the hands and feet? 2 weeks. (6) Spasticity of both lower limbs?2 weeks. (7) Dribbling of urine and constipation?2 weeks. (8) Difficulty in swallowing?15 days. His father stated that he himself had suffered from gonorrhoea sixteen years previously and from syphilis twelve years previously but that his son had not been ill until six weeks ago when he complained of severe headache and became unconscious. During the first two hours of the coma some involuntary movements of the face, hands and feet were noticed. His abdomen became distended and he passed a motion in bed with much flatus, which relieved the distension. He vomited once and remained unconscious for three days, without taking food and without passing any motion. After these three days he asked for food and spoke frequently. But he remained completely deaf. This condition continued for a month when fifteen days before admission he became unable to speak. Involuntary movements in the limbs now appeared. Urine was passed in small quantities every hour or so and the bowels were never moved without a purgative. Seven days before admission the father noticed that the patient had increasing difficulty in swallowing.