Rating Parkinson's Disease: A Contemporary Eye to Archival Patients

In this article, we present a detailed analysis of archival films of 12 different patients with Parkinson's disease (PD). This unique collection of films was made by Arthur Van Gehuchten (1861-1914), the first professor of neurology in Belgium at the turn of the 20th century. These extraordinarily well-preserved century-old documents are a precise iconography of PD before encephalitis lethargica swept the world and with clinical features unaffected by treatments such as levodopa. In view of the universal interest of the International Parkinson and Movement Disorder Society-sponsored revision of the UPDRS (MDS-UPDRS) in evaluating patients with PD, we based our analysis on this scale. Of course, given the lack of detailed clinical files and the impossibility of rating a number of items, rating disease severity in a strict clinimetric sense could not be achieved. However, we did this exercise in order to place these one-century-old cases in a modern perspective. In most patients, we could score numerous items of the motor examination part of the MDS-UPDRS. These archival documents constitute a superb lesson in the semiology of PD, which keeps today its fresh didactical value.