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"Neurologic Examination - history"
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Performing neurology : the dramaturgy of Dr. Jean-Martin Charcot
\"This text provides a study of Jean-Martin Charcot, a founding figure in the history of neurology as a discipline and a colleague of Sigmund Freud. It argues that Charcot's diagnostic and pedagogic models, explaining both how disease is recognized and described and how to teach the act of neurological diagnosis, should be considered through a theatrical lens. Considering the constitution of the living, moving body in terms of performance, Charcot created a situation whereby the line between deceptive acting and real pathology, scientific accuracy and creative falsehood, and indeed between health and unhealth, becomes blurred. The physician becomes a medical subject in his or her own display, transforming medicine into a potentially destabilizing, even grand guignolesque, discourse\"-- Back cover.
Book
The history of examination of reflexes
In the late 1800s, Wilhelm Erb, Joseph Babinski, William Gowers, and others helped develop the neurologic examination as we know it today. Erb was one of the first to emphasize a detailed and systematic neurologic exam and was co-discoverer of the muscle stretch reflex, Gowers began studying the knee jerk shortly after it was described, and Babinski focused on finding reliable signs that could differentiate organic from hysterical paralysis. These physicians and others emphasized the bedside examination of reflexes, which have been an important part of the neurologic examination ever since. This review will focus on the history of the examination of the following muscle stretch and superficial/cutaneous reflexes: knee jerk, jaw jerk, deep abdominal reflexes, superficial abdominal reflexes, plantar reflex/Babinski sign, and palmomental reflex. The history of reflex grading will also be discussed.
Journal Article
History of the ‘geste antagoniste’ sign in cervical dystonia
The
geste antagoniste
is a voluntary maneuver that temporarily reduces the severity of dystonic posture or movements. It is a classical feature of focal and particularly cervical dystonia. However, the precise historical aspects of
geste antagoniste
still remain obscure. The goals of this review were (1) to clarify the origin of the
geste antagoniste
sign; (2) to identify the factors that led to its diffusion in the international literature; (3) to follow the evolution of that term across the twentieth century. We used medical and neurological French, German and English literature of the late nineteenth and early twentieth centuries, and the PubMed database by entering the terms
geste antagoniste
,
antagonistic gesture
and
sensory trick
. The
geste antagoniste
sign is a legacy of the Paris Neurological School of the end of the nineteenth century. The term was introduced by Meige and Feindel in their 1902 book on tics, written in the vein of their master, Brissaud, who first described this sign in 1893. The almost immediate translations of this book by Giese into German and Kinnier Wilson into English contributed to the rapid spreading of the term
geste antagoniste
, which is still in use worldwide today. The term
antagonistic gesture
is the translation proposed by Kinnier Wilson, which also led to the use of the term
geste antagonistique
. The
geste antagoniste
sign has long been considered a solid argument for the psychogenic origins of dystonia until the 1980s when Marsden made strong arguments for its organic nature.
Journal Article
C. Miller Fisher and the Comatose Patient
Neurologic examination of the comatose patient has gradually matured. Less than 50 years ago, neurological examination in coma became a regular part of textbooks with separate chapters devoted to the topic but many were deficient in detail. In 1969, C.M. Fisher published an extraordinary 56-page paper on the examination of the comatose patient. The paper—one of Fisher’s gems—is not well known and infrequently cited. The many new observations collected in this comprehensive paper are reviewed in this vignette, which highlights not only how these contributions shaped our thinking on coma but also questioned shaky concepts.
Journal Article
Origin of DSS: to present the plan
The Disability Status Scale for multiple sclerosis was the direct result of World War II, in which 16.4 million persons served in the US military. Thereafter academic medicine enabled the modernization of the Veterans Administration in patient care, research, and training.
Under the GI Bill, I attended Cornell University Medical College, where there was an intensive course in neurological diagnosis requiring detailed recording of positive and negative findings. This was used in junior and senior clinical clerkships and residency training, all of which I took at the Bronx VA Hospital.
During my residency we assessed a possible treatment for MS, which required a comparison group and a means of measuring change. The former comprised the records of over 300 MS patients, whose neurological deficits were then consolidated into mutually exclusive Functional Systems, each with grades for severity. As rank-order scales they could not be summed or compared directly, but they were used as the basis for the DSS, which ranged from 0 (normal) to 10 (death due to MS). This scale was later expanded into the EDSS by halving each step 1 through 9. This bifid system is applicable to all patients with MS regardless of type or severity of neurological impairment.
Journal Article
In Search of a Conceptualization of Multiple Sclerosis: A Historical Perspective
A thorough understanding of Multiple Sclerosis (MS) is necessary to offer individuals informed options for treatment and planning. To assist in this quest, the following historical analysis examined how MS has been conceived from the 14th century through the early 20th century. Primary sources were consulted whenever possible, and many of the original archival materials were accessed by the first author (MB) during an on-site visit to the Rare Book Room of the New York Academy of Medicine. There is a striking similarity between how MS symptoms have presented throughout history compared with the 21st century. Sensorimotor and cognitive sequelae have been observed in patients since the 1800s. Cognitive symptoms were acknowledged in the 1800s, but disregarded in the early 1900s and were not given recognition again until the latter part of the 20th century. If conceptualizations of MS are inaccurate, patients will not be served well. In contrast to the shared symptomatology across time, early conceptualizations of etiology and treatment choices differed dramatically from today, a genuine reflection of the times in which they were created.
Journal Article
