Neuropsychiatric interpretations of postencephalitic movement disorders

This study reviews the impact of encephalitis lethargica (EL) on concepts of behaviour and movement during the 1920s and 1930s. Clinicopathological correlations were imprecise but supported the role of subcortical structures in complex patterns of motor behaviour. This possibility challenged the wid...

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Bibliographic Details
Published in:Movement disorders 2003-06, Vol.18 (6), p.623-630
Main Author: Ward, Christopher D.
Format: Article
Language:English
Subjects:
Acute Disease
Behavior Control - methods
Biological and medical sciences
Catalepsy - etiology
Catalepsy - history
Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes
Dystonia - etiology
Dystonia - history
encephalitis lethargica
Female
History, 20th Century
Humans
Male
Medical sciences
Movement Disorders - epidemiology
Movement Disorders - history
Movement Disorders - psychology
Movement Disorders - therapy
Nervous system (semeiology, syndromes)
Neurology
Neurotic Disorders - history
Parkinson Disease, Postencephalitic - epidemiology
Parkinson Disease, Postencephalitic - history
Parkinson Disease, Postencephalitic - psychology
Parkinson Disease, Postencephalitic - therapy
psychogenic disorders
Psychophysiologic Disorders - history
volition
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Summary:This study reviews the impact of encephalitis lethargica (EL) on concepts of behaviour and movement during the 1920s and 1930s. Clinicopathological correlations were imprecise but supported the role of subcortical structures in complex patterns of motor behaviour. This possibility challenged the widely assumed hegemony of the cerebral cortex. There was a perceived link between involuntary movements and reduced impulse control and also between parkinsonism and a defect in volition. Contemporary observers interpreted postencephalitic phenomena such as oculogyria in psychodynamic as well as in neurophysiological terms. EL also gave some support to the idea that neuroses such as obsessional neurosis and hysteria might have an organic basis. These speculations recently have acquired more credibility. The large amount of literature on EL and its sequelae could perhaps make further contributions to understanding the pathology of voluntary movement and action. © 2003 Movement Disorder Society
ISSN:0885-3185
1531-8257
DOI:10.1002/mds.10413