TUMORS IN TIIE ROLANDIC, OR SO CALLED MOTOR, REGION usually give rise to definite localizing symptoms. In the irritative stage of tumors of the cortex, these are Jacksonian epilepsy, involving the muscles of the face, arm, or leg, ac cording to the seat of the growth, and sensory disturbance, often in the form of aura and numb or tingling sensations, limited to the regions involved in the con vulsive movements. After the lesion be comes destructive in character, weakness or paralysis of the affected muscles takes place. As a rule, after every Jacksonian convulsion, the muscles involved in this are weak or paralyzed for a short time. The muscles first affected in the con vulsion are the last to cease jerking, are the weakest, and denote the seat of the irritation in the brain. It is important to study the initial phenomena and the order in which one group of muscles after another is involved by the convul sion, as these afford aid in localizing the primary seat of the brain-lesion, espe cially early in the history of the disease.
In some cases, probably those in which the irritation is limited to the cortex, the seizure may, for a time, consist of pain, numb or tingling sensations, lim ited to the distal portion of an extremity, or these may immediately precede a con vulsive movement, which always begins in the part in which the sensory dis turbance is first felt. When the con vulsion begins in, or decidedly affects, the muscles of the lower face of either side, but most pronounced when the right is involved, temporary motor apha sia often follows the attack. Some sub jective sensory loss, in the distal portion of the limb, is common in tumors of the motor cortex. According to Dana, the sense of localization is most affected.