European sleeping sickness
| Classification according to ICD-10 | |
|---|---|
| A85.8 | Encephalitis lethargica sive epidemica |
| ICD-10 online (WHO version 2019) | |
The European sleeping sickness , encephalitis lethargica or encephalitis epidemic (synonyms: (Von) Economo's disease , encephalitis Vienna ) is an inflammation of the brain , the lethargy , uncontrollable sleep attacks and a temporary, of Parkinson's disease triggers similar disorder. A neurotropic virus is assumed to be the pathogen.
history
The disease occurred in Europe between around 1915 and 1927 and was also named after Constantin von Economo , who first described it in 1916.
People fell asleep while eating or at work. Headache, nausea and fever often followed the next day. Those affected often fell asleep in completely uncomfortable postures. They could be woken up, but in the worse cases a quick death followed. About a third of those affected died of the disease. Eye muscle paralysis, particularly oculomotor nerve dysfunction and eyelid paralysis, were common, described Economo. He researched similar case reports from previous centuries in Europe.
The leading specialist in Germany was the neurologist Felix Stern , who examined the first cases as an assistant doctor in Kiel and published an article about it in March 1920. At the Göttingen University Hospital, he was in charge of building Germany's first special ward for patients with encephalitis lethargica in the 1920s. There he researched and treated hundreds of patients in all stages of the disease and described their course pattern up to the end stage, which led to almost complete immobility in many patients. At the time, Stern found only minor macroscopic inflammation foci, but no noticeable similarities in the autopsy of the brains of those affected. His work made him known beyond the borders of Germany and resulted in his book Die Epidemische Encephalitis (1922), which quickly became a standard work.
Between 1917 and 1927 there was a particular accumulation of encephalitis lethargica cases. Estimates go from 500,000 to a million diseases; Stern estimated the number of people affected in Germany at 60,000. After that there was no more epidemic-like occurrence, new cases were only described in individual cases up to the 1940s. Due to the almost simultaneous occurrence of encephalitis lethargica with the Spanish flu , Stern (who later revoked this thesis) and later Ravenholt and Foege in 1982 suspected that these two diseases were linked. However, McCall and colleagues were able to 2001, no influenza - RNA detected in archived tissue samples and therefore do not confirm this assumption. The herpes virus and the scarlet fever pathogen were also temporarily suspected of being responsible for the outbreak of the disease.
Howard and Lees documented four cases in 1987.
Trivia
- Oliver Sacks ' book Awakenings is about victims of this epidemic around 1920, with whom the author met in the late 1960s as a young doctor in the neurological nursing department of a hospital in the USA. Sacks was able to briefly bring patients to consciousness with L-dopa , a precursor of the neurotransmitter dopamine . The film Time of Awakening is based on this book.
- The author Susanne Schäfer claims in her autobiographical book "Stars, Apples and Round Glass" that she developed numerous sequelae as a result of encephalitis lethargica , including autism , narcolepsy and epilepsy .
literature
- MS Dickman: from Economo encephalitis. . In: Archives of Neurology . Volume 58, number 10, October 2001, ISSN 0003-9942 , pp. 1696-1698 (PDF; 74 kB).
- RR Dourmashkin: What caused the 1918-30 epidemic of encephalitis lethargica? In: Journal of the Royal Society of Medicine. Volume 90, Number 9, September 1997, pp. 515-520, ISSN 0141-0768 . PMID 9370993 . PMC 1296535 (free full text).
- Constantin von Economo : The encephalitis lethargica. Deuticke Verlag, Leipzig / Vienna 1918 ( digitized in the Internet Archive ).
- Felix Stern : The Epidemic Encephalitis. (= Monographs from the entire field of neurology and psychiatry, volume 30). Springer, Berlin 1922, DOI: 10.1007 / 978-3-662-35278-6 (2nd edition, Springer, Berlin 1928, DOI: 10.1007 / 978-3-642-90811-8 ).
- Felix Stern: The pathology of the so-called "encephalitis lethargica". In: Archives for Psychiatry and Nervous Diseases. Volume 61 (1920), Issue 3, pp. 621-692, DOI: 10.1007 / BF01910029 .
- Karl Wurm, AM Walter: Infectious Diseases. In: Ludwig Heilmeyer (ed.): Textbook of internal medicine. Springer-Verlag, Berlin / Göttingen / Heidelberg 1955; 2nd edition, ibid. 1961, pp. 9-223, here: pp. 191-194.
Web links
- European sleeping sickness. In: Orphanet (Rare Disease Database).
- European sleeping sickness . In: MedLexi.de
- Christian Honey: On the trail of the sleep epidemic. In: Spektrum.de , January 25, 2019.
Individual evidence
- ^ A b Russell C. Dale, Andrew J. Church, Robert AH Surtees et al: Encephalitis lethargica syndrome: 20 new cases and evidence of basal ganglia autoimmunity . In: Brain . Vol. 127, No. 1 , 2004, p. 21-33 , doi : 10.1093 / brain / awh008 , PMID 14570817 (English). , (Full text) , accessed February 16, 2013.
- ↑ Peter Reuter: Springer Lexicon Medicine. Springer, Berlin a. a. 2004, ISBN 3-540-20412-1 , p. 1924.
- ^ Paul Foley: Beans, roots and leaves: A brief history of the pharmacological therapy of parkinsonism. In: Würzburg medical history reports. Volume 22, 2003, pp. 215-234, here: pp. 221-223.
- ↑ Felix Stern: The epidemic encephalitis. 2nd Edition. Julius Springer, Berlin 1928.
- ↑ Christian Honey: On the trail of the sleep epidemic . In: Spektrum.de, January 25, 2019.
- ^ R. Howard, A. Lees: Encephalitic lethargica: a report of four recent cases. In: Brain. 110, 1987, pp. 19-28.
- ↑ Oliver Sacks: Dawn of consciousness. On the history of the wake-up drug L-DOPA . Deutscher Verlag der Wissenschaften, Berlin 1989, ISBN 3-326-00349-8 .
- ↑ Susanne Schäfer: Stars, apples and round glass. 5th edition. Free Spiritual Life Publishing House, Stuttgart 2012, ISBN 978-3-7725-1814-0 .
