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Postencephalitic parkinsonism--a review

J Casals¹, T S Elizan, M D Yahr

¹Department of Neurology, Mt. Sinai School of Medicine, City University of New York, NY 10029, USA.

Journal of Neural Transmission (Vienna, Austria : 1996)

|November 24, 1998

Summary

The 1917 von Economo's disease (ED) pandemic predated the 1918 influenza pandemic. While a viral cause for ED is debated, evidence like IgG bands and brain lesions suggests a viral etiology, distinct from influenza.

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Area of Science:

Neurology
Epidemiology
Virology

Background:

The 1917 von Economo's disease (ED) pandemic occurred before the 1918 influenza pandemic.
The causal link between influenza and ED is questioned, as ED began over a year earlier.
The etiology of ED remains uncertain, with no virus isolated from patients.

Purpose of the Study:

To review the evidence for a viral etiology of von Economo's disease.
To discuss the relationship between von Economo's disease and Parkinson's disease.
To evaluate the distinct clinical presentation of parkinsonism in ED compared to other viral encephalitides.

Main Methods:

Review of historical pandemic data.
Analysis of clinical and pathological findings in suspected ED cases.
Comparison of parkinsonism in ED with other viral neurological disorders.

Main Results:

Oligoclonal IgG bands in cerebrospinal fluid (CSF) suggest an immune response within the central nervous system.
Autopsy findings reveal chronic active brain lesions consistent with a viral infection.
Parkinsonism in ED differs clinically from that caused by other neurotropic viruses.

Conclusions:

A viral etiology for von Economo's disease is suggested by immunological and pathological evidence.
ED is distinct from influenza, and its parkinsonism is unique.
Further research is needed to identify the specific virus responsible for ED.

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