AMYOTROPHIC LATERAL SCLEROSIS WITH INVOLVEMENT OF POSTERIOR COLUMN AND SENSORY DISTURBANCES

Amyotrophic lateral sclerosis, correctly regarded as a disease of the motor system, occasionally involves other neural structures, and cases have been recorded in which it was associated with mental symptoms 1 and sensory disturbances of both peripheral 2 and central nature. The question always arose whether the changes in the sensory pathways formed part of the picture of amyotrophic lateral sclerosis or were chance associations in the course of Charcot's disease. Another question is whether or not the degeneration of the pyramidal tract, posterior column and anterior horn cells is the result of a combined system disease, possibly on the basis of pernicious anemia. The following two cases in which degeneration of the posterior columns was present in clinically and pathologically typical syndromes of amyotrophic lateral sclerosis illustrate once more the occurrence of sensory disturbances in the "pure" motor syndrome. REPORT OF CASES Case 1. —M. F., a man aged