Abstract

Post-encephalitic Parkinsonism is a disease believed to be caused by a viral illness that triggers degeneration of the nerve cells in the substantia nigra. Overall, this degeneration leads to clinical parkinsonism.

Historically, starting in 1917 an epidemic of encephalitis lethargica, also called von Economo’s encephalitis or "sleepy-disease" occurred, possibly related to the 1918 Spanish flu pandemic; however, even with the use of modern molecular diagnostic tests on appropriate corpses no firm link between encephalitis lethargica with influenza has been made. Although parkinsonism was occasionally seen during the acute

encephalitic phase of encephalitis lethargica, it was often encountered in the post-encephalitic phase. The onset of post encephalitic

parkinsonism can be delayed by several years from the resolution of encephalitis lethargica.

The brain regions affected contain neurofibrillary tangles, similar to those seen in Alzheimer's disease. Nevertheless, the senile plaques common in Alzheimer's disease are not found.

Cultural references

The film "Awakenings" (starring Robin Williams and Robert De Niro) and its respective book based on genuine cases reported by Oliver Sacks deal with sensitive and largely accurate topics relating to this disease. The state of the art in treatment remains roughly the same as it was at the time of the events depicted, the 1960s, although patients with post-encephalitic Parkinsonism lose benefit from their medication far faster than do patients with Parkinson's disease.