Psychosomatic Medicine 14:161-173 (1952)
© 1952 American Psychosomatic Society

Psychosomatic Aspects of Encephalomyelopathy with Muscle Atrophy

¹ Section of Neurology, Winter Veterans Administration Hospital, Topeka, Kansas

Five cases of encephalopathy associated with syndromes of progressive muscular atrophy, amyotrophic lateral sclerosis, and a nonspecific muscular atrophy, as well as with psychic disturbances, are described. Generalized muscular wasting characterized each patient and widespread fasciculations were prominent in all but Case 5. Cases 1 and 3 demonstrated bulbar symptoms. In Cases 1, 3 and 4, electromyographic studies of the fasciculations, as presented in detail by Teitelbaum and Bird (24), indicated that the site of origin lay peripheral to the anterior horn cells, in all likelihood, at the myoneural junctions. The abnormal amounts of creatine in the urine of all five patients indicated that the muscle degeneration, observed clinically and confirmed by biopsy, continued during hospitalization. Examination of the spinal fluid revealed no significant activity. In three patients, including patient 4 who refused to undergo oxyencephalography, electroencephalographic tracings were abnormal. The air studies in four cases demonstrated cortical atrophy.

The psychic disturbances present in the above cases are discussed on both physiological and psychological levels as manifestations of personality deviations which are expressions of the premorbid personalities of the patients.