Atypical Poliomyelitis (Gilliam, 1938)
Epidemic Neuromyasthenia (Ramsay)
Location and Date:
Los Angeles County General Hospital, 1934
Described by:
Alexander Gordon Gilliam (1938) – Epidemiological study of an epidemic, diagnosed as poliomyelitis, occurring among the personnel of the Los Angeles county general hospital during the summer of 1934
Symptoms:
First considered as poliomyelitis (polio).
Initial symptoms similar to polio, but some features differed from polio:
- Localized muscle weakness in 80% of cases, yet no muscle wasting (unlike polio)
- No evidence of damage to the lower motor neuron
- Sensory symptoms (persisting far longer than in polio)
- Muscle pain, tenderness (persisting far longer than in polio)
- Fatigue on walking short distances
- Lapses of memory
- Loss of concentration
- Sleep disturbances
- Emotional lability (with "hysterical episodes")
- Reoccurrence of both systemic and neurological symptoms, some cases more disabled by recurrence than by original illness
- No mortality, but high morbidity (55% of staff off duty six month after peak of peidemic)
- Vaso-moto and trophic disturbances
- Excessive sweating or abnormal dryness of the skin of the extremities
- Coldness and cyanosis
- In more severe cases exfoliation of the skin
- Hypertrichosis and brittleness of the nails, with retardation or acceleration of growth
The outbreak in the Royal Free Hospital in London in 1955 was an almost exact replica of this outbreak according to A. Melvin Ramsay.
Source:
A. Melvin Ramsay – "Myalgic Encephalomyelitis – The saga of the Royal Free disease", page 12
.