Congenital Atonic Diplegia

By J. N. (BERRY, M D., M.R.C.P., D.C.H. (From the MediwrlrCollege Hospital, Nagpur, India) Hypotonia in cerebral diplegia is relatively are and when present is often associated with choreo-athetotic movements and is present in the peripheral segments in between tonic spasms. Cases with marked inco-ordination and hypotonia are due to a cerebellar component. Wilson (1940) divides such cases into three types : (1) Diplegia with cerebellar symptoms : cerebro-cerebellar diplegia. (2) Atonic diplegia (atonic-astasic type of Foerester). (3) Cerebellar diplegia (congenital cerebellar ataxia of Batten). He includes all these under the heading of cerebellar diplegia. But, to quote the same author, Wilson (1940): ' The asynergy is doubtless cerebellar, but whether abnormal limb excursions and joint extensibility, as well as loss of tone, are more than an extreme degree of what can be found in distal parts of infantile (cerebral) hemiplegic or diplegic limbs is not altogether clear \ Brain (1947) does not mention atonic diplegia but probably includes it in his cases of cerebellar diplegia covering those which show hypotonia and ataxia.