FORMS OF FAMILIAL ATAXIA RESEMBLING MULTIPLE SCLEROSIS

Abstract

Amid prolonged discussion of the etiology, pathologic characteristics and treatment of multiple sclerosis, its clinical study has been neglected. Diagnosis of the disease has become a trite exercise, reserved for beginners. Yet to one with experience the extreme variability of the symptomatology makes the diagnosis a distinct problem. The famous triad of Charcot—nystagmus, intention tremor and scanning speech-means only disease of cerebellar connections and may appear in several conditions. In cases in which there are onset at an early age, definite remissions and undoubtedly disseminated lesions, leading eventually to incapacitation, there is not often much debate, but the incomplete syndromes, the apparently arrested forms and, particularly, the nonremittent, progressively paraplegic types lead to much confusion. Wide divergences in symptomatology between "typical" cases make it probable that multiple sclerosis as it is diagnosed at present may in reality represent several morbid entities. An attempt to delimit some of these groups and