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June 21, 1919

UNILATERAL ANESTHESIA OF THE CORNEA AND CONJUNCTIVAA DIAGNOSTIC SIGN OF COMA DUE TO HEMIPLEGIA

Author Affiliations

Instructor in Medicine, University and Bellevue Hospital Medical College; Adjunct Assistant Attending Physician, Third Medical Division, Bellevue Hospital NEW YORK

JAMA. 1919;72(25):1812-1813. doi:10.1001/jama.1919.02610250012005
Abstract

A physician may at any time be confronted with the necessity of determining the cause of coma; it is often difficult to say whether one is dealing with a postepileptic state, uremia, some toxic condition, or hysteria. We have found a sign which has been of great value in establishing the diagnosis of coma due to hemiplegia. It is known that in profound coma all reflexes are abolished; but in cases of moderate stupor or confused states this sign has helped to establish the diagnosis. The sign is a unilateral anesthesia of the cornea on the side of the hemiplegia, that is, the side opposite the lesion.

It has long been known and recently emphasized that the unilateral diminution, or absence of the abdominal wall reflexes, is an important sign of hemiplegia. We have found that in some instances, particularly in women with flabby abdominal musculature, it is difficult to

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