(seq. 10)

MADELAINE R. BROWN, M.D.
264 BEACON STREET
BOSTON, MASS.

February 23, 1943

Dr. Eleanor Pavenstedt
Reformatory for Women
Framingham, Massachusetts

[SMK?]
File (in our office)

Dear Dr. Pavenstedt,

Miss Barbara Brown came in to the Nerve Clinic at the
Massachusetts General Hospital this morning.

On neurological examination she had a -20 diopters
myopia in both eyes, but the disc edge was normal. There
was no nystagmus, convergence was good. The extra-
ocular muscles were normal. Hearing was good. The
bone conduction was about the same as air conduction.
There was no wax against the drums today, though she says
she has to have it removed every two weeks. There was
no numbness of the face. The tongue and palate moved
in the midline. There was no weakness or incoordination
of the extremities. There was a fine tremor of the
extended hands, more on the right, no rigidity. There
was no sensory loss. Vibration sense was normal in the
arms and legs. In the Romberg she swayed a bit to the
left with her eyes closed and was perfectly steady thereafter.
The deep tendon reflexes were normal. When walking she
tended to go a little bit to the left but turned quickly
and her balance was good.

The urine specimen showe a one plus albumin and 3-5
white cells.

Diagnosis: I see no evidence of multiple sclerosis, and
the tremor is probably familial. The swaying I believe
to be functional in origin. These dizzy attacks which
she mentions came on only when she was in jail as a
witness in the perjury case and at other times when she
was under a s train. The attacks of peri-oral numbness,
one attack when she lost sensation all over the body for
two days and the occasion when she could not raise her
head for two weeks after the lumbar puncture appear to
be hysterical in origin. Miss Brown tells me that she
is applying for the WAACs, and since I have been doing
their neuro-psychiatric examinations with Dr. Florence
Clothier, I suppose I would see her. In the first place