As contribuições de Charcot e de Marsden para o desenvolvimento dos distúrbios do movimento nos séculos XIX e XX

Abstract

Charcot contribuiu significativamente no século XIX na descrição de várias enfermidades neurológicas, em particular na área dos distúrbios do movimento. Charcot contribuiu de forma exponencial na descrição clínica minuciosa da doença de Parkinson, além de introduzir o primeiro tratamento farmacológico. Na área das hipercinesias realizou estudos sobre a síndrome de Tourette, o diagnóstico diferencial dos tremores, das coréias e o estudo inicial sobre startle. Marsden, recentemente falecido, destacou-se no século XX com inúmeras publicações na área dos movimentos anormais.São contribuições seminais os estudos sobre a doença de Parkinson, distonias, mioclonias , tremor essencial, a descrição das síndromes " Painful Legs Moving Toes ", "Gait Ignition Failure" e o "Tremor Primário da Escrita". As contribuições de Charcot no século XIX e de Marsden no século XX na área dos distúrbios do movimento permitem concluir que ambos foram as figuras mais representativas desta área nos últimos dois séculos.

Jean-Martin Charcot: the polymath

“…Charcot's observations also encompassed descriptions of various non-motor symptoms and signs. 33,[39][40][41][42] It is essential to recall that Charcot and Vulpian coined the term "Maladie de Parkinson," known earlier as "Shaking Palsy," in 1862. 39,43 In 1892, Charcot presented a lecture on vibration therapy, discussing his clinical experience with PD using a vibratory chair.…”

“…Additionally, he was the first to introduce anticholinergic treatment for tremor. 27,[39][40][41][42] Charcot conducted extensive research on "aphasia" and delivered lectures at La Salpêtrière, which were later transcribed and published by Charles Féré. [46][47][48][49][50] Gaetano Rummo (1853-1917) translated and transcribed these lectures into Italian, which resulted in the book "Differenti forme d'aphasia," published in 1884.…”

Dementia in Parkinson's Disease: A Clinical Review

“…LBD is a syndrome clinically defined and consists of a primary form of dementia characterized by visual-perceptual alterations and executive dysfunction accompanied by (McKeith et al, 2005) prominent visual hallucinations (Lyketsos et al, 2007), fluctuation of attention and parkinsonism (Teive et al, 2001;Lanska, 2010). The presence of the typical cognitive profile with at least two of these three central characteristics set the diagnosis of probable LBD (McKeith et al, 2005).…”

“…The cognitive symptoms in PD were classically neglected since its original description by James Parkinson, from which an erroneous culture was established in which cognitive functions remained unchanged in the course of the disease. In the late nineteenth century Charcot already anticipated, however, that there is also cognitive impairment in PD (Teive et al, 2001;Lanska, 2010).…”

Evolution of the concept of dystonia

“…Marsden was the most important researcher of movement disorders in the 20 th century. He participated of an ad hoc committee of Scientific Advisory Board of the Dystonia Medical Research Foundation that developed the concept of dystonia in 1984, "a syndrome consisting of sustained muscle contractions, frequently causing twisting and repetitive movements, or abnormal postures", accepts until 2013 11,12 . The definition from 1984 was seminal, but several shortcomings had recognized: (1) the expression "sustained muscle contractions" refers to one specific manifestation of dystonia, and implies exclusion of less sustained manifestations; (2) the quality of "abnormal postures" was not specified; (3) certain characteristic qualities of dystonia, such as the patterned and stereotypical nature of movements within an individual, the role played by movement initiation, and overflow activation of extraneous muscles, are not adequately represented.…”