Psychopathology of forced movements and the oculogyric crises of lethargic encephalitis / by Smith Ely Jelliffe.

  • Jelliffe, Smith Ely, 1866-1945.
Date:
1932
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Licence: In copyright

Credit: Psychopathology of forced movements and the oculogyric crises of lethargic encephalitis / by Smith Ely Jelliffe. Source: Wellcome Collection.

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    Vorkastner observed them in a patient with presenile paralysis agitans. And patients suffering from epilepsy, syphilis,5 tumor of the brain, multiple sclerosis, cerebral abscess, hemiplegia, general paralysis, were known to have presented the phenomena under consideration, as seen from a clinical angle. (See Bibliography.) Then came the deluge of the encephalitic cases after von Econo- mo’s important study. In 1921, Oeckinghaus related the earliest case here found directly related to encephalitis. Staehelin is fre¬ quently cited as having reported the first case, but after reading his paper carefully I feel that his case was a prelethal convulsive seizure in an acute encephalitis with well known eye movements, and does not belong in the group under consideration. Then Gabrielle Levy, in her magnificent thesis, reported two excellent case histories. My reading of these cases does not entirely correspond to that of Roger and Reboul-Lachaux. From then on, as to be found in a following chapter, a hundred and more observers have occupied themselves with the problems presented, and over 200 case histories are here brought together. Houin offered (1922) an early collected study.6 Lubrano (1926), in his thesis, collected about forty-six cases of the type under discussion. The kind of oculocephalogyric crises that follow in the wake of epidemic encephalitis, while standing out as striking and apparently isolated phenomena, are really but parts of a much enlarged general picture with which neurologists are familiar. This is the general hypertonic or hyperkinetic, dyskinetic picture—the amyostatic syn¬ drome of Strumpell, and particularly in encephalitic parkinsonism— out of which the oculogyric crises are here artificially isolated and intensively studied. Most observers of these encephalitic oculocephalogyric crises have emphasized the rarity of these syndromes; on the other hand, Stern spoke of their frequency. As an example, Bing, in 1926, wrote that he had seen only three in 300 cases. In as many cases, Wimmer had but five to report, whereas Stern found twenty in 100 of his cases. Van Bogaert and associates collected twenty-five cases within four to five years in Antwerp. In the present study I do not offer statistics as I have seen most of the great number of cases I have observed but superficially in the clinics of Europe and the Ehiited States. In the year 1928, however, I saw four cases in private consultation work, 5 See Pearson’s rich bibliography and work by Krabbe. 6 Not yet obtained by me.