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The globus pallidus in post-encephalitic parkinsonism

1965; Elsevier BV; Volume: 2; Issue: 4 Linguagem: Inglês

10.1016/0022-510x(65)90018-3

1878-5883

J. Purdon Martin,

Neurological and metabolic disorders

In nine cases of post-encephalitic parkinsonism forty years after the infection, the globus pallidus has been examined to determine whether there were lesions comparable to those which caused severe loss of postural reflexes in experimental monkeys, as described by various workers. In three cases in which the patients had been completely disabled by postural reflex loss there was degeneration of nerve cells throughout the pallidum, to such a degree that it was doubtful whether any normal cells remained in the outer segment, and few remained in the inner segment. The fibre content of the nucleus was very much diminished, and the whole nucleus was greatly shrunken. By contrast, in the three least disabled patients, although considerable parts of the pallidum were degenerated, many normal cells remained in the rest of the ganglion, and in many sections the number and quality of the nerve cells were such that parts of both segments had a normal, or almost normal appearance. The fibre content was also very much greater than in the first group. The remaining cases were intermediate between these two contrasted groups, both clinically and pathologically, and so in the series as a whole there was a general correspondence between the degree of postural loss and the amount of degenerative change in the pallidum. Although theoretically the postural reflex arcs might be interrupted elsewhere, in this series of cases it seems probable, judging from the published experimental work, that the degree of damage in the pallidum is sufficient to account for all the lower loss of postural reflexes, i.e., for all the ‘negative’ symptoms. The substantia nigra was equally degenerated in all the cases.