ON A PECULIAR FORM OF INFANTILE CONVULSIONS (HYPSARRHYTHMIA) AS DESCRIBED IN HIS OWN INFANT SON BY DR. W. J. WEST IN 1841

Abstract

In a poignant letter to the Lancet in 1841 Dr. W. J. West clearly described infantile spasms and the accompanying mental subnormality. The patient was his own son and the letter below is an anguished appeal for possible help for West's son from readers of the Lancet. TO the Editor of THE LANCET:- Sir:-I beg, through your valuable Journal, to call the attention of the medical profession to a very rare and singular species of convulsion peculiar to young children. As the only case I have witnessed is in my own child, I shall be very grateful to any member of the profession who can give me any information on the subject, either privately or through your excellent Publication. The child is now near a year old; was a remarkably fine, healthy child when born, and continued to thrive till he was four months old. It was at this time that I first observed slight bobbings of the head forward, which I then regarded as a trick, but were, in fact, the first indications of disease; for these bobbings increased in frequency, and at length because so frequent and powerful, as to cause a complete heaving of the head forward towards his knees, and then immediately relaxing into the upright position, something similar to the attacks of emprosthotonos: these bowings and relaxings would be repeated alternately at intervals of a few seconds, and repeated from ten to twenty or more times at each attack, which attack would not continue more than two or three minutes; he sometimes has two, three, or more attacks in the day; they come on whether sitting or lying; just before they come on he is all alive and in motion, making a strange noise, and then all of a sudden down goes his head and upwards his knees; he then appears frightened and screams out: at one time he lost flesh, looked pale and exhausted, but latterly he has regained his good looks, and, independent of this affection, is a fine grown child, but he neither possesses theintellectual vivacity or the power of moving his limbs, of a child of his age; he never cries at the time of the attacks, or smiles or takes any notice, but looks placid and pitiful, yet his hearing and vision are good; he has no power of holding himself upright or using his limbs, and his head falls without support.