No abstract

CHICAGODeafness resulting from meningococcic meningitis is a well recognized complication. Neal's 1 series of 650 cases contained 26 instances of deafness, Cook, Lyon and Mitchell 2 reported deafness in 3 of a series of 87 cases. McLean and Caffey3 reported deafness in 4 of 44 cases. Eleven cases of deafness were noted in 144 instances of epidemic meningitis by Smithburn, Kempf, Zerfas and Gilman.4 It is usually stated that the deafness has little tendency to improve and that it is due to a lesion of the auditory nerve.Oppenheim 5 stated that the lesion consists of purulent invasion of the eighth cranial nerve, with extension to or actual involvement of the cochlea and the meninges in the original assault by the meningococcus. Earlier writers 6 (Moos, Steinbrugge and Schultze) found the eighth cranial nerve hyperemic and infiltrated with cells in the early stages and later bathed in pus. Steinbrugge observed a case in which the nerve fibers were entirely destroyed. Schultze reported a case of meningitic deafness in which the eighth cranial nerve was atrophic and sclerotic. Recent writings on the pathologic picture and the pathogenesis

of 130 units, the second convulsion developed at 9:24 a. m. A third convulsion occurred on the thirty-first treatment day, with a dose of 120 units, at 9: 20 a. m. The fourth and last convulsion occurred at 9: 54 a. m. on the thirty-seventh treat¬ ment day, with a dose of 85 units. In all, the patient had twenty-eight comas, and hypoglycémie shock therapy was ter¬ minated July 22 because of fracture dislocation of the left Downloaded From: http://jama.jamanetwork.com/ by a Carleton University User on 06/20/2015

No abstract