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vulsions." I have purposely quoted the opinions of authorita- tive clinicians and hold that in spite of the sharp division of opinion, convulsions do occur during dentition and at rare times become so formidable as to seriously threaten life. The mechanism that initiates the eclamptic seizure Alesse Mg is Alesse Ocp not discussed 770 ROSENHECK: REFLEX CONVULSIONS DURING DENTITION. [New York Medical Journ/ here. The pathways by which peripheral sensory stimuH are transformed Alesse Cost into excessive motor mani- festations are quite devious and intricate. Order Alesse Online It is rather the persistence of the convulsive attacks that is emphasized. An analysis of the causes under- lying the continuance of Alesse 21 the morbid process will elucidate the problem and justify the use of the therapeutic measures proposed. It is assumed that at the height of the convulsive attack there results an intense congestion of the cerebral sinuses and veins. This state of affairs must affect the free flow of cerebrospinal fluid in the ventricles, communicating channels, and suba- rachnoid spaces of brain and cord. If the attack is not repeated, the venous congestion subsides and the flow of cerebrospinal fluid is reestablished. However, if the convtilsions are repeated, the initial venous congestion and interference with the free passage of the cerebrospinal fluid is increased im- measurably. A vicious circle is thus created, each Purchase Alesse succeeding eclamptic seizure adding greater diffi- culties to the overburdened ventricles and blood spaces. Finally an acute hydrocephalus develops. This increased intracephalic pressure is without doubt responsible for the continuation of the con- vulsions. Upon this point the observations of M. Baumes made 135 years ago are worthy of note. He states : "Acute hydrocephalus, whether we con- sider it as a result of cerebral plethora, or whether it be derived from a morbid affection of the serous membrane of the brain, or whether it be caused by the imperfect absorption of the humour which lubricates the ventricles of the organ, has a close connection with difficult dentition." It is this verv "imperfect absorption of the humour which lubri- cates the ventricles" that perpetuates the convul- sions and menaces the infant's existence. Naturally the use of lumbar puncture to relieve this pressure at once Alesse Price suggests itself and has been used in three cases under my observation with striking effect. The convulsive attacks were coincident with the eruption of teeth, the persistent spasms were clonic and tonic in character, and had consistently defied the usual Alesse Vs Aviane remedial measures. Lumbar puncture showed the cerebrospinal Yaz Vs Alesse fluid to be under con- siderable tension and Alesse Generics the removal of an adequate amount was followed by a cessation of the attacks. One of the cases under the care of Dr. S. A. Jahss is worthy of an extended note. This child was wont to have a series of Alesse Generic Brand convulsions with the erup- tion of every tooth. Its health was Buy Alesse unimpared in the interim. The number Alesse Acne of attacks would increase with each succeeding tooth and Buy Alesse Online the intervals be- tween the spasms were so shortened that the con- vulsions were almost continuous. The last attack lasted twenty-seven hours and Doctor Jahss noticed that the child during this entire period was Alesse Discontinued Alesse Vs Yaz never relaxed; clonic convulsions were followed at once by tonic spasms in the entire somatic musculature. Heroic medication seemed to have no effect, and the precarious condition of the child was quite evi- dent. The coma was absolute and the Alesse For Acne signs of in- creasing intraventricular pressure were quite mani- fest. By lumbar puncture about forty-five c. c. of fluid vrere Aviane Vs Alesse withdrawn under a great deal of tension. The convulsions stopped, the muscles gradually relaxed, and the child fell ipto a quiet slumber of several hours' duration. There was moderate stupor and a state of muscular as- thenia in the ensuing twenty-four hours, followed by a complete and uninterrupted recovery. Naturally so radical a method Alesse And Acne for treating the reflex convulsions of dentition is hardly advocated as a routine measure. Other well tried methods are available and no doubt are just as efficacious. It is only for those rare cases where the convulsions per- sist and an acute hydrocephalus develops that lum- bar puncture is recommended. 370 CicNTRAL Park West.

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