In 1878, Erb1 described a form of bulbar paralysis with ptosis and weakness of the muscles of the jaws and neck, with atrophy and diminution of the electrical excitability which he called asthenic bulbar paralysis. In 1887, Oppenheim2 described a similar form and stated that no particular microscopic changes were found by him or by Jolly who studied the tissues microscopically. He spoke of this condition as a progressive fatal neurosis with glossopharyngolabial paralysis without atrophy. Wilks, Eisenlohr, Karplus, Hoppe and others reported similar cases with marked dysarthria, dysphagia, weakness of the muscles of the tongue, palate and jaws, and fatigue of the trunk muscles. Goldflam,3 in 1893, also described a similar form of bulbar paralysis, and stated that ptosis was a constant symptom, with fatigability of the muscles of mastication and deglutition and with bulbar speech. Many more such cases were reported later by Jolly, Strümpell,