Section of the spinal cord (at levels C.4, Th.10 and L.4) showing bilateral degeneration of crossed and direct pyramidal tracts, and a section of the medulla showing degeneration of both pyramids. This material comes from a case of encephalitis peri-axialis diffusa (Schilder's disease). In this condition (whose cause is unknown) patches of demyelinization occur here and there in the white matter of the cerebral hemisphere. In this case, the pyramidal tracts on both sides have clearly been extensively involved. Commonly, also, the optic radiations become affected, leading to blindness. The progressive paralysis of all the limbs which usually occurs in this condition terminates fatally in a few years.

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