Encephalitis lethargica

Encephalitis lethargica is an atypical form of encephalitis.

Encephalitis Lethargica, also known as sleeping sickness (though different from the sleeping sicknesstransmitted by the tsetse fly), is a devastating illness that swept the world in the 1920's and then, vanished as soon as it had appeared.

Encephalitis Lethargica attacks the brain, leaving some victims like living statues, speechless and motionless. It is as if the victims go to sleep and not wake up.

During the outbreak, over a million died, and some were left frozen inside their useless bodies, in institutions.

Between 1917and 1928, an epidemicof encephalitis lethargica spread throughout the world, but no recurrence of the epidemic has since been reported, though isolated cases continue to occur.

Symptoms

It is characterized by high fever, headache, double vision, delayed physical and mental response, and lethargy. In acute cases, patients may enter coma. Patients may also experience abnormal eyemovements, upper body weakness, muscular pains, tremors, neck rigidity, and behavioral changes including psychosis.

Postencephalitic Parkinson's diseasemay develop after a bout of encephalitis, sometimes as long as a year after the illness.

Cause

The cause of encephalitis lethargica is not yet known for certain, but on the basis of research by Britishdoctors Russell Daleand Andrew Church, the disease is now thought to be due to a massive immune reactionto an infection by the streptococcus-like bacterium, diplococcus. There is also some evidence of an autoimmuneorigin.

Treatment

Treatment for encephalitis lethargica in the early stages is patient stabilisation, which may be very difficult. There is little evidence so far of a consistent effective treatment for the initial stages, though one patient who was given steroids initially has so far made a good recovery. Other patients have been less fortunate, and the disease then becomes progressive, with evidence of brain damage similar to Parkinson's disease. Treatment is then symptomatic. Levodopa(L-Dopa) and other antiparkinson drugs often produce dramatic responses. However in most of the patients who were given L-Dopa in the 1960s, the amelioration of the disease was short lived.

The course of encephalitis lethargica varies depending upon complications or accompanying disorders.

Popular culture

The discovery that levodopa could produce some amelioration of the symptoms was described in the book Awakenings by Oliver Sacks, later made into a film starring Robin Williamsand Robert De Niro.

The encephalitis lethargica epidemic of 1917-1928has also appeared in comic book literature in Neil Gaiman's Sandmangraphic novels, where in the very first story he ascribes the "sleeping sickness" to Morpheus' imprisonment.

References

• National Institute of Neurological Disorders and Stroke
• Mystery of the Forgotten Plague: BBC news item about the tracing of the infectious agent in encephalitis lethargica
• BBC health article on encephalitis lethargica
• lethargica/encephalitis_lethargica.htmde:Europäische Schlafkrankheit

nl:Encephalitis lethargica

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It uses material from the http://en.wikipedia.org/wiki/Encephalitis+lethargica Wikipedia article Encephalitis lethargica.