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Posey and Spiller and progressive supranuclear palsy: an incorrect attribution
A D Siderowf1, S L Galetta, H I Hurtig
1Department of Neurology, University of Rochester Medical Center, New York, USA.
Summary
The earliest reported case of progressive supranuclear palsy was actually a midbrain neoplasm, not the disease itself. Autopsy findings confirmed a tumor, not progressive supranuclear palsy.
Area of Science:
- Neurology
- Neuroscience
- Pathology
Background:
- Historical medical case reports by Posey and Spiller (1904-1905) described a patient with progressive ophthalmoparesis and imbalance.
- This case was widely considered the earliest documented instance of progressive supranuclear palsy (PSP).
- No autopsy was initially believed to have been performed on this patient.
Discussion:
- This report re-examines the clinical history of the patient described by Posey and Spiller.
- It presents findings from a subsequent autopsy performed by Spiller in 1906.
- The autopsy revealed a tumor located in the right cerebral peduncle and periaqueductal area.
Key Insights:
- The autopsy definitively identified a midbrain neoplasm as the cause of the patient's symptoms.
- These findings conclusively demonstrate that the patient did not have progressive supranuclear palsy.
- This reclassification impacts the historical understanding of early PSP case studies.
Outlook:
- Revisiting historical case studies with modern diagnostic insights is crucial for accurate disease classification.
- Clarifying the etiology of historical neurological cases refines our understanding of neurodegenerative diseases.
- Future research may involve re-evaluating other early case reports using available pathological data.