Funtabulously Frivolous Friday Five 103
Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia FFFF, introducing the Funtabulously Frivolous Friday Five 103
Question 1
Who was de Musset, and why do we still refer to him?
Reveal the funtabulous answer
Alfred de Musset (1810-1857) was a French romantic poet and playwright.
His brother Dr Paul de Musset (1804-1880) remarked to him that his head regularly nodded and de Musset reportedly stopped it temporarily by placing his thumb and forefinger on his neck.
de Musset sign is one of the eponymous findings of aortic regurgitation.
- Zhang G. Eponyms in Aortic Regurgitation. LITFL 2019
- de Musset P. Biographie de Alfred de Musset. 1877: 267 and 316
- Delpeuch A. Le signe de Musset: secousses rhythmées de la tête chez les aortiques. La Presse médicale. 1900; 8: 237-238
Question 2
In Britain Hoover this is a common brand of vacuum cleaner and the Americans have a dam with the same name, but what does ‘Hoover sign‘ mean to neurologists?
Reveal the funtabulous answer
Hoover’s sign is used to help determine if leg paresis is organic or not.
Placing a hand under the heel of the non-affected leg, the examiner asks the patient to raise the weak leg.
- With a genuine (organic) deficit, you would expect to feel the normal heel push down as the weak leg attempts to rise.
- In functional (non-organic) weakness, there is no movement of the normal heel.
Dr Charles Franklin Hoover (1865–1927), a physician in Cleveland, Ohio, described his useful principle and two tests in the Journal of the American Medical Association in 1908
- Hoover CF. A new sign for the detection of malingering and functional paresis of the lower extremities. Journal of the American Medical Association, 1908; LI(9): 746-747
- Stone J, Sharpe M. Hoover’s Sign. Practical Neurology 2001;1: 50-53. [PDF]
Question 3
What is erythema ab igne and why is it making a comeback?
Reveal the funtabulous answer
The translation of this dermatological term is “redness from fire“.
It was most commonly associated with an older population applying hot water bottles to the skin to reduce pain.
However, there are an increasing number of case reports in a younger demographic secondary to heat exposure from laptops and other electronic device (toasted skin syndrome)
- Laptop-induced erythema ab igne: Report and review of literature. Riahi RR, Cohen PR
- Arnold AW, Itin PH. Laptop Computer–Induced Erythema ab Igne in a Child and Review of the Literature
Question 4
Your elderly patient is concerned that she is going crazy because she keep seeing “little people” scurrying around the house. Given that she lives alone, what might this be?
Reveal the funtabulous answer
A form of visual hallucination that relates to severely impaired vision rather than mental illness. Typically patients will describe seeing small people or objects and be aware that they are not real.
Charles Bonnet (1720-1793) first noted this phenomenon in his elderly grandfather who suffered from bilateral cataracts and regularly claimed to witness ‘men, women, birds, physically impossible circumstances and scaffolding patterns‘
- Bonnet C. Essai analytique sur les facultés de l’ame. 1760 p426-428
Question 5
What is the Will Rogers phenomenon?
Reveal the funtabulous answer
The Will Rogers phenomenon is an epidemiological paradox that occurs when moving an element from one set to another set raises the average values of both sets. The best example is Sir Robert Muldoon’s (former Prime Minister of New Zealand) response to a query about trans-Tasman migration:
New Zealanders who emigrate to Australia raise the IQ of both countries.
The ‘Will Rogers phenomenon‘ is named after a remark made by the humorist Will Rogers who had similar views to Muldoon about migration from Oklamhoma to California during the American economic depression of the 1930’s.
The name was proposed in 1985 by Alvan Feinstein to describe the ‘stage migration’ he observed in patients with cancer. It has since been described as occurring ina many conditions, including multiple sclerosis with the advent of the imaging-assisted McDonald criteria.
The phenomenon is dangerous as improvements in prognosis over time may be spuriously attributed to treatments rather than stage migration.
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Funtabulously Frivolous Friday Five
Medical Registrar fascinated by the quirky history of medicine and those crazy microbes.