A Midsummer Night’s Gene: The familial Neurological Illness of Felix Mendelssohn

Abstract

Felix Mendelssohn Bartholdy (1805–1847) is widely regarded as one of the musical geniuses of the Romantic period. A prodigy akin to Mozart, Mendelssohn composed piano works, symphonies, and concertos at an early age but died young, at 38. His death has been attributed to neurological disease, but the mystery of his diagnosis is amplified by the fact that his sisters died under similar circumstances, including the renowned composer, Fanny Mendelssohn Hensel. Mendelssohn died after years of suffering from headaches, earaches, and mood disturbances. In the final year of his life, his acute decline was marked by stepwise, progressive neurologic deficits: gait disturbance, loss of sensation in the hands, partial paralysis, and, finally, loss of consciousness. The similar pattern of disease within his family suggests an underlying genetic link, though this may be multifactorial in nature. We present a thorough, posthumous differential diagnosis for Mendelssohn's illness, given his medical history, the familial pattern, and hints from within his music. Possible diagnoses include ruptured cerebral aneurysm with resultant subarachnoid hemorrhage, familial cerebral cavernous malformation, and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Continued research into Mendelssohn's life may yield more information about his illness, death, and possibly true diagnosis.