Cardiac arrhythmia in relation to cerebral anaemia and epileptiform crises / by Alfred Webster, M.D., Fellow of the Faculty of Physicians and Surgeons, Glasgow.

  • Webster, Alfred.
Date:
[1901]
Catalogue details

Licence: In copyright

Credit: Cardiac arrhythmia in relation to cerebral anaemia and epileptiform crises / by Alfred Webster, M.D., Fellow of the Faculty of Physicians and Surgeons, Glasgow. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    Considerable interest and importance attach to the report of- Bristowe’s case, more especially as that observer lays great stress on the fact that, while the pulse was beating at the rate of 1 beat in 3 or 4 seconds, no fit occurred ; but that whenever, and only when, the intermission was prolonged to 5 seconds an epileptiform seizure followed at the end of that period. It would appear, however, that with such short periods of suspension of the pulse many of these attacks were of the nature of minor epileptiform manifestations. Hodgson’s case is scarcely of less importance and interest, and is in striking contrast to that reported by Bristowe, for here such periods as 15 seconds of pulse suspension were merely associated with faintness, and epileptiform attacks only supervened after such lengthened periods of pulselessness as 30 seconds. This case, in some ways perhaps, more closely resembles our own than do any of the others. Notably it presented these exceptionally long periods of asphyxia ; another point of similarity being that on occasions the seizures occurred in such rapid succession that only a second or two elapsed between two attacks. In this case also we have the first mention of the fall in the blood pressure being indicated on the sphygmographic tracing. Jones and Clinch’s case is interesting in that it is accom- panied by sphygmographic evidence, which is conspicuous by its absence from most of the other records. Here we note also that considerable intervals, sometimes as long as 15 seconds, elapsed between pulse beats, and the lowest rate of cardiac contraction was eight beats per minute (by auscultation). On some occasions, however, the pulse rate rose to 60 per minute. The variation in intensity and extent of the convulsive attacks is very notable. Pugin Thornton and Pansome’s case is remarkable for the similarity of the description of the convulsive attacks to those of Holberton and Burnett. The case reported by Hay was another of those in which very long periods of asphyxia preceded the convulsive attacks and the crescendo reappearance of the pulse on the return to consciousness. Before referring to Tripier’s cases it will be here convenient