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September 1919


Author Affiliations

Attending Neurologist, Cook County Hospital CHICAGO

From the pathology laboratories of Cook County and Psychopathic Hospitals, Chicago.

Arch NeurPsych. 1919;2(3):261-270. doi:10.1001/archneurpsyc.1919.02180090011002

After Duchenne's first description of progressive bulbar paralysis1 this disease was generally looked on as an independent clinical and pathologic entity. Later, numerous observations showed that it may form a part of the clinical pictures of amyotrophic lateral sclerosis, of chronic anterior poliomyelitis (subacute general anterior spinal paralysis of Duchenne) and progressive muscular atrophy (type Aran-Duchenne). The symptoms and signs are sometimes so confusing that a differential diagnosis between these four types is very difficult, and some authors (Starr,2 Gowers3) have come to look on at least some of these conditions as practically identical diseases. The following clinico-pathologic report tends to demonstrate the identity of amyotrophic lateral sclerosis and chronic bulbar paralysis.

REPORT OF A CASE  Mrs. E. R., 62 years old, admitted on Dec. 13, 1918, to the county hospital, service of Dr. Frederick Tice, complaining of difficulty in swallowing, talking and walking, about one and