Residua and Sequelae of Epidemic Encephalitis

Goodhart, Sandor

doi:10.1001/jama.1925.02660270036011

Cited by 10 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A key distinguishing criterion, however, was that cognition was impaired in dementia praecox as it was, according to Hoch, in ''benign stupors.'' 70 Cognition was generally claimed to be near-normal in EL 32,53,71,72,73 The ARNMD deemed the term 'catatonia' misleading in EL (Ref. Patients had ''a curious immobility which gave them an air of apathy.''…”

Section: Lethargy As a Mental Disorder Lethargy And Hysterical Sleepmentioning

confidence: 99%

On doing nothing: Descriptions of sleep, fatigue, and motivation in encephalitis lethargica

Ward

2011

Movement Disorders

View full text Add to dashboard Cite

Epidemics of encephalitis lethargica (EL), from 1917 to the 1930s, are an important milestone in the history of movement disorders. Today, the two best-known features of EL are somnolence and parkinsonism but the full clinical picture was variable and complex. States of wakeful inactivity--as opposed to drowsiness--were often described both in the acute and postacute stages and were referred to in the EL literature as "lethargy" or "torpor." The study described here is based on a survey of clinical descriptions published in English, French, and German from 1917 to 1942. Its focus is on the history of clinical ideas, rather than applying modern pathophysiological concepts retrospectively. Descriptions of lethargy are explored as a way of elucidating concepts of sleep, fatigue, and motivation during the study period. The literature described many patients who had (1) lethargy without interruption in consciousness; (2) slowness of movement and catalepsy without other prominent parkinsonian features; and (3) apathy and lack of initiative without severe disorders of mood or thought content. Hence observers distinguished a state of wakeful inactivity from primary disorders of sleep, movement and behavior. Contemporaneous accounts suggest that writers had difficulty in reconciling their observations with preexisting concepts; there still may be limitations in our ability to describe and classify the clinical states connected during the epidemic era with the term "lethargy."

show abstract

Section: Lethargy As a Mental Disorder Lethargy And Hysterical Sleepmentioning

confidence: 99%

On doing nothing: Descriptions of sleep, fatigue, and motivation in encephalitis lethargica

Ward

2011

Movement Disorders

View full text Add to dashboard Cite

show abstract

“…And, during this period there were consistent questions as to the relationship between PEP and idiopathic Parkinsonism (PD), with some clinicians of the time (especially the French clinicians) insisting that PEP and PD were identical (including etiology). 17,30,31 Additionally, the amyostatic-akinetic form of EL was not a consistent form of EL. Von Economo 1 stated that the amyostatic form of EL was particularly prevalent in some EL epidemics, such as that in London in 1918, and Hamburg in 1919.…”

Section: Historical Review Of El Reports Pertaining To Parkinsonismmentioning

confidence: 99%

Does the historical literature on encephalitis lethargica support a simple (direct) relationship with postencephalitic Parkinsonism?

2010

View full text Add to dashboard Cite

This article and the subsequent one suggest that the currently accepted view of a simplistic (direct) relationship between encephalitis lethargica (EL) and postencephalitic Parkinsonism (PEP) is based on a incomplete evaluation of the epidemic period literature. In this article we provide a detailed analysis of the literature from the period that demonstrates that Parkinsonism was not initially part of acute EL symptomatology, that PEP was not typically the prevailing type of chronic EL and that oculogyric crises were never part of acute EL symptomatology and not initially associated with PEP. The second paper uses these finding, and also examines the clinical justifications for concluding that all patients with PEP had prior acute episodes of EL, to reevaluate the presumed direct etiologic relationship between EL and PEP.

show abstract

“…In addition to catalepsy, catatonia comprised “hypertonia .. motor barrage and negativism, motor repetitions …, passive obedience, mannerism, and deficit in gestural expression, as well as vasomotor and trophic troubles.”48 The relationship between EL and catatonic psychosis was widely discussed 28, 41, 68, 69. A key distinguishing criterion, however, was that cognition was impaired in dementia praecox as it was, according to Hoch, in “benign stupors.”70 Cognition was generally claimed to be near‐normal in EL32, 53, 71, 72, 73 The ARNMD deemed the term “catatonia” misleading in EL 28. According to Economo, EL produced “lucid catatonic stupor (Ref 3,.…”

Section: Lethargy As a Mental Disordermentioning

confidence: 99%

Phase II trial of irinotecan plus cisplatin in patients with recurrent or metastatic squamous carcinoma of the head and neck

Gilbert

Cmelak

Shyr

et al. 2008

Cancer

View full text Add to dashboard Cite

BACKGROUND.Patients with recurrent or metastatic HNC have a poor response and survival with currently available chemotherapy agents. Thus, new agents are needed. The authors report the results of a phase II trial of irinotecan and cisplatin in patients with metastatic or recurrent HNC.METHODS.Patients were treated with irinotecan 65 mg/m2 IV over 90 minutes and cisplatin 30 mg/m2 were administered intravenously weekly for four weeks, followed by a two week rest. However, after 17 patients were treated with weekly irinotecan at a dose of 65 mg/m2, toxicity analysis demonstrated the poor tolerance of that dose in this patient population. Thus, the protocol was amended, and irinotecan was dose reduced to a starting dose of 50 mg/m2. Twenty‐three additional patients were treated with this dose.RESULTS.Forty patients were enrolled on study between February 2002 and April 2006, 17 patients at the first dose level and 23 patients at the amended dose level. Overall, 12 of 17 patients (71%) treated with irinotecan 65 mg/m2 experienced clinically significant grade 3 or 4 toxicity. Twelve patients required dose reductions. Toxicity was reduced but 17% of patients still experienced grade 3 or 4 toxicity on the lower irinotecan dose. The response rate was 35% for patients treated at irinotecan 65 mg/m2 and 22% for patients treated at 50 mg/m2. No complete responses were noted.CONCLUSIONS.The combination of irinotecan and cisplatin is efficacious in a poor prognosis group of patients but toxicity is substantial. Cancer 2008. © 2008 American Cancer Society.

show abstract

Residua and Sequelae of Epidemic Encephalitis

Cited by 10 publications

References 0 publications

On doing nothing: Descriptions of sleep, fatigue, and motivation in encephalitis lethargica

On doing nothing: Descriptions of sleep, fatigue, and motivation in encephalitis lethargica

Does the historical literature on encephalitis lethargica support a simple (direct) relationship with postencephalitic Parkinsonism?

Phase II trial of irinotecan plus cisplatin in patients with recurrent or metastatic squamous carcinoma of the head and neck

Contact Info

Product

Resources

About