Neuropsychiatric interpretations of postencephalitic movement disorders

• 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
• ISSN: 0885-3185; 1531-8257
• DOI: 10.1002/mds.10413

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