A case of giant tonsils.

Case history Mr. D.M., aged 51 years, a crofter from the Isle of Barra, was admitted to the Orthopaedic Department of the Western Infirmary, Glasgow, on 26 June 1970. Eight days prior to admission he had developed pain in the back of the neck, radiating to both shoulders and down both arms, following trivial injury to the neck while lifting a dustbin. He was treated with cervical collar and analgesics. The pain disappeared after three days. On 24 June 1970 he developed slight weakness of the grip in both hands and paraesthesia of both hands. He also had slurring of speech and dysphagia. He was able to swallow only small bits at a time. About eighteen months previously he had had a prolapsed intervertebral disc in the lumbar region and this continued to trouble him intermittently. X-ray of the cervical spine showed evidence of cervical spondylosis. He was seen by Mr. T. W. Howard, Orthopaedic Surgeon, who did not think that the radiological feature and trivial injury suffered by the patient explained the weakness and muscle wasting of small muscles of the hands and flexor muscles of the fingers.