History of the deficiency diseases of the nervous system

Type of article: ORIGINAL

AUTHOR

M. Balcells
Department of Neurology. Hospital Universitari del Sagrat Cor, Barcelona, Spain.

ABSTRACT

Introduction. Mankind's earliest written accounts and images prove that deficiency diseases of the nervous system have been recognised throughout history. These diseases were originally caused by famines and armed conflict, and prisoners of war were frequent victims. Alcohol consumption, in addition to poor nutrition, became another cause of deficiency diseases of the nervous system from the late 19th century onward. The purpose of this article is twofold. Firstly, we wish to present the earliest descriptions of the deficiency diseases of the nervous system. Secondly, the article aims to show that diagnosing certain clinical entities, for example, vitamin B12 deficiency, requires an interdisciplinary approach.

Material and Methods. Our study is based mainly on initial descriptions of a specific syndrome or clinical feature. These articles were located in the the Spanish Society of Neurology's historical archive, and we also searched the MEDLINE and Índice Médico Español (IME) databases to gather additional literature.

Conclusions. A number of syndromes once regarded as separate clinical entities have been grouped together, as in the case of Wernicke-Korsakoff syndrome. However, some patients present clinical and pathological manifestations pertaining to several different entities: nutritional amblyopia, for example, may present with lesions specific to Wernicke-Korsakoff syndrome. The clinical features that have been described confirm that interdisciplinary studies are needed in order to gain more thorough knowledge of these entities.

KEYWORDS

Deficiency diseases of the nervous system, Wernicke-Korsakoff syndrome, pellagra, beriberi, Marchiafava-Bignami disease, central pontine myelinolysis, cortical cerebellar degeneration, nutritional amblyopia

Neurosciences and History 2014;2(4):156-169