Encephalitis lethargica: The challenge of structure and function in neuropsychiatry

Abstract

From its initial description, encephalitis lethargica (EL) challenged the existing understanding of neurology, psychiatry, neurophysiology, and neuropathology in multiple areas, including disease classification, states of alertness, the phenomenology of sleep and consciousness, the voluntary and involuntary control of thought and movement, and the neural underpinnings of emotional and behavioral phenomena (which in turn had important legal ramifications in assessing criminal culpability), not to mention the interrelationship of neural and endocrine systems. This paper reviews the phenomenology of EL, highlighting some of the puzzles it generated by demonstrating that abstract notions of consciousness, sleep, thought, volition, and will were in fact intimately connected to brain function in regions not formerly suspected of subserving such roles.

Keywords

• encephalitis lethargica
• neuropsychiatry
• von economo