The Chronicity in Lethargic Encephalitis

Abstract

During the past eighteen months over two hundred cases of lethargic encephalitis have come under our care, chiefly in Mount Sinai Hospital and in consultation at the Jewish Hospital, Brooklyn. The febrile stage of most of these patients lasted from ten to twenty days. When that stage was passed and convalescence was well established, they were discharged from the hospital. As a visiting physician watching the passage of these patients through our intern service, I at first thought lethargic encephalitis was an infectious disease of sudden onset and of rapid course which, if terminating happily, would be followed by a less rapid but complete recovery. The cases of some patients undoubtedly conformed to this view ; others, in which the acute stage differed in no way, halted in their recovery and were forced to return to the Outpatient Department for further treatment. Still other patients survived the acute phase only to enter a chronic progressive stage. With every month that passed, more of these unfortunates returned. The early optimism I enjoyed quickly perished, and I learned to dread this disease, so often fatal, not infrequently

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

“…The outstretched arms may fall and be raised at will only to fall again.'' 38 Grossman failed to demonstrate myasthenic fatigability and found it ''difficult to distinguish physically-based hypotonia from the effects of 'mental torpor.''' 39 Claude considered the asthenia of EL to be a reduction in psychic rather than muscle tone; it was ''a form of fatigability, which renders all activities difficult or impossible'' 40 ; he and others used the term ''psychic asthenia.''…”

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

“…The outstretched arms may fall and be raised at will only to fall again.'' 38 Grossman failed to demonstrate myasthenic fatigability and found it ''difficult to distinguish physically-based hypotonia from the effects of 'mental torpor.''' 39 Claude considered the asthenia of EL to be a reduction in psychic rather than muscle tone; it was ''a form of fatigability, which renders all activities difficult or impossible'' 40 ; he and others used the term ''psychic asthenia.''…”

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

“…p. 11). Abrahamson wrote that “… The outstretched arms may fall and be raised at will only to fall again.”38 Grossman failed to demonstrate myasthenic fatigability and found it “difficult to distinguish physically‐based hypotonia from the effects of ‘mental torpor.’”39 Claude considered the asthenia of EL to be a reduction in psychic rather than muscle tone; it was “a form of fatigability, which renders all activities difficult or impossible”40; he and others used the term “psychic asthenia.”40–42 Stern described a continuum of states. First there were terms primarily suggesting fatigue or sleepiness including “Müdigkeitsgefühl” (fatigue feelings associated with drowsiness), “dösiger Schläfrigheit” (stupor/sleepiness) and “Schlafdämmern” (sleep‐twilight state).…”

Relational Troubles and Semiofficial Suspicion: Educators and the Medicalization of “Unruly” Children

“…Schools have been associated with ADHD and its conceptual precursors for decades, as evidenced by the early clinical literature that linked inattention and hyper‐activity to the onset of encephalitis lethargica, or “sleepy sickness” (Abrahamson 1920; Ebaugh 1923; Kennedy 1924; Strecker 1929; Stryker 1925). This literature argued that the psychological after‐effects of encephalitis were responsible for a variety of antisocial behaviors in children, including the avoidance of school obligations (Rafalovich 2001a).…”

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

“…The outstretched arms may fall and be raised at will only to fall again.'' 38 Grossman failed to demonstrate myasthenic fatigability and found it ''difficult to distinguish physically-based hypotonia from the effects of 'mental torpor.''' 39 Claude considered the asthenia of EL to be a reduction in psychic rather than muscle tone; it was ''a form of fatigability, which renders all activities difficult or impossible'' 40 ; he and others used the term ''psychic asthenia.''…”

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

“…p. 11). Abrahamson wrote that “… The outstretched arms may fall and be raised at will only to fall again.”38 Grossman failed to demonstrate myasthenic fatigability and found it “difficult to distinguish physically‐based hypotonia from the effects of ‘mental torpor.’”39 Claude considered the asthenia of EL to be a reduction in psychic rather than muscle tone; it was “a form of fatigability, which renders all activities difficult or impossible”40; he and others used the term “psychic asthenia.”40–42 Stern described a continuum of states. First there were terms primarily suggesting fatigue or sleepiness including “Müdigkeitsgefühl” (fatigue feelings associated with drowsiness), “dösiger Schläfrigheit” (stupor/sleepiness) and “Schlafdämmern” (sleep‐twilight state).…”

Relational Troubles and Semiofficial Suspicion: Educators and the Medicalization of “Unruly” Children

“…Schools have been associated with ADHD and its conceptual precursors for decades, as evidenced by the early clinical literature that linked inattention and hyper‐activity to the onset of encephalitis lethargica, or “sleepy sickness” (Abrahamson 1920; Ebaugh 1923; Kennedy 1924; Strecker 1929; Stryker 1925). This literature argued that the psychological after‐effects of encephalitis were responsible for a variety of antisocial behaviors in children, including the avoidance of school obligations (Rafalovich 2001a).…”

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

“…The outstretched arms may fall and be raised at will only to fall again.'' 38 Grossman failed to demonstrate myasthenic fatigability and found it ''difficult to distinguish physically-based hypotonia from the effects of 'mental torpor.''' 39 Claude considered the asthenia of EL to be a reduction in psychic rather than muscle tone; it was ''a form of fatigability, which renders all activities difficult or impossible'' 40 ; he and others used the term ''psychic asthenia.''…”

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

“…p. 11). Abrahamson wrote that “… The outstretched arms may fall and be raised at will only to fall again.”38 Grossman failed to demonstrate myasthenic fatigability and found it “difficult to distinguish physically‐based hypotonia from the effects of ‘mental torpor.’”39 Claude considered the asthenia of EL to be a reduction in psychic rather than muscle tone; it was “a form of fatigability, which renders all activities difficult or impossible”40; he and others used the term “psychic asthenia.”40–42 Stern described a continuum of states. First there were terms primarily suggesting fatigue or sleepiness including “Müdigkeitsgefühl” (fatigue feelings associated with drowsiness), “dösiger Schläfrigheit” (stupor/sleepiness) and “Schlafdämmern” (sleep‐twilight state).…”

Relational Troubles and Semiofficial Suspicion: Educators and the Medicalization of “Unruly” Children

“…Schools have been associated with ADHD and its conceptual precursors for decades, as evidenced by the early clinical literature that linked inattention and hyper‐activity to the onset of encephalitis lethargica, or “sleepy sickness” (Abrahamson 1920; Ebaugh 1923; Kennedy 1924; Strecker 1929; Stryker 1925). This literature argued that the psychological after‐effects of encephalitis were responsible for a variety of antisocial behaviors in children, including the avoidance of school obligations (Rafalovich 2001a).…”