Psychology Wiki
Register
Advertisement

Assessment | Biopsychology | Comparative | Cognitive | Developmental | Language | Individual differences | Personality | Philosophy | Social |
Methods | Statistics | Clinical | Educational | Industrial | Professional items | World psychology |

Clinical: Approaches · Group therapy · Techniques · Types of problem · Areas of specialism · Taxonomies · Therapeutic issues · Modes of delivery · Model translation project · Personal experiences ·


General paresis
ICD-10 A521
ICD-9 090.40 094.1
OMIM [1]
DiseasesDB [2]
MedlinePlus [3]
eMedicine /
MeSH {{{MeshNumber}}}
This article is about the neuropsychiatric disorder. For the physical malady, paralysis, see paresis.

General paresis, also known as general paralysis of the insane or paralytic dementia, is a now-rare neuropsychiatric disorder affecting the brain and central nervous system, caused by syphilis infection. It had been considered a psychiatric disorder before and during the nineteenth century, when it was first scientifically identified and discovered to be extremely common, because the patient usually first sought—or was brought for—treatment because of psychotic symptoms of sudden and often dramatic onset.

Diagnosis[]

The diagnosis could be differentiated from other known psychoses by a characteristic abnormality in eye pupil reflexes (Argyll Robertson pupil), and, eventually, the development of muscular reflex abnormalities, seizures, memory impairment (dementia) and other signs of relatively pervasive neurocerebral deterioration.

Prognosis[]

Although there were recorded cases of remission of the symptoms, especially if they had not passed beyond the stage of psychosis, these individuals almost invariably suffered relapse within a few months to a few years. Otherwise, the patient was seldom able to return home because of the complexity, severity and unmanageability of the evolving symptom picture. Eventually, the patient would become completely incapacitated, bedfast, and die, the process taking about three to five years on average.

History[]

While retrospective studies have found earlier instances of what may have been the same disorder, the first clearly identified examples of paresis among the insane were described in Paris after the Napoleonic Wars. General paresis of the insane was first described as a distinct disease in 1822 by Antoine Laurent Jesse Bayle. General paresis most often struck people (men far more frequently than women) between twenty and forty years of age. By 1877, for example, the superintendent of an asylum for men in New York reported that in his institution this disorder accounted for more than twelve percent of the admissions and more than two percent of the deaths.

Originally, the cause was believed to be an inherent weakness of character or constitution. While Esmarch and Jessen had asserted as early as 1857 that syphilis caused general paresis, progress toward the general acceptance by the medical community of this idea was only accomplished later by the eminent nineteenth-century syphilographer Alfred Fournier (18321914). In 1913 all doubt about the syphilitic nature of paresis was finally eliminated when Noguchi and Moore demonstrated the syphillitic spirochaetes in the brains of paretics.

In 1917 Julius Wagner-Jauregg discovered that infecting paretic patients with malaria could halt the progression of general paresis. He won a Nobel Prize for this discovery in 1927. After World War II the use of penicillin to treat syphilis made general paresis a rarity: even patients manifesting early symptoms of actual general paresis were capable of full recovery with a course of penicillin. The disorder is now virtually unknown outside Third World countries, and even there the epidemiology is substantially reduced.

See also[]

References[]

Alon, G., Sunnerhagen, K. S., Geurts, A. C. H., & Ohry, A. (2003). A home-based, self-administered stimulation program to improve selected hand functions of chronic stroke: NeuroRehabilitation Vol 18(3) 2003, 215-225.

*Alzheimer, A. (1991). Arteriosclerotic brain atrophy: International Journal of Geriatric Psychiatry Vol 6(3) Mar 1991, 129-130.
*Bechter, K. (1995). Research strategies in "slow" infections in psychiatry: History of Psychiatry Vol 6(24, Pt 4) Dec 1995, 503-511.
*Bonifer, N. M., Anderson, K. M., & Arciniegas, D. B. (2005). Constraint-induced therapy for moderate chronic upper extremity impairment after stroke: Brain Injury Vol 19(5) May 2005, 323-330.
*Castillo, J. L., Cea, J. G., Verdugo, R. J., & Cartier, L. (1999). Sensory dysfunction in HTLV-I-associated myelopathy/tropical spastic paraparesis: A comprehensive neurophysiological study: European Neurology Vol 42(1) Jul 1999, 17-22.
*Cocchi, R., & Maniscalco, M. (1990). Disappearance of spontaneous nystagmus in 3 encephalopathic children receiving drug therapy: Italian Journal of Intellective Impairment Vol 3(2) Nov 1990, 321-326.
*Coleman, J. H., & et al. (1976). Neurological manifestations of chronic marihuana intoxication. Part I: Paresis of the fourth cranial nerve: Diseases of the Nervous System Vol 37(1) Jan 1976, 29.
*da Silva, J. A. G. (2006). "Basilar impression associated with impacted cisterna magna, spastic paraparesis and distress of balance:" Reply: Arquivos de Neuro-Psiquiatria Vol 64(4) Dec 2006, 1053.
*Damasio, A. R., McKee, J., & Damasio, H. (1979). Determinants of performance in color anomia: Brain and Language Vol 7(1) Jan 1979, 74-85.
*Dobias, J. (1970). Dementia and deterioration: Ceskoslovenska Psychiatrie Vol 66(3) Jun 1970, 173-176.
*Duffy, J. D. (1995). General paralysis of the insane: Neuropsychiatry's first challenge: Journal of Neuropsychiatry & Clinical Neurosciences Vol 7(2) Spr 1995, 243-249.
*Farina, E., Mariani, C., Abbiati, C., & Perani, D. (1994). General paresis: Neuropsychological and SPECT study of five cases: Italian Journal of Neurological Sciences Vol 15(5) Jun 1994, 229-237.
*Grichting, B., Hediger, V., Kaluzny, P., & Wiesendanger, M. (2000). Impaired proactive and reactive grip force control in chronic hemiparetic patients: Clinical Neurophysiology Vol 111(9) Sep 2000, 1661-1671.
*Hesse, S. (2004). Recovery of gait and other motor functions after stroke: Novel physical and pharmacological treatment strategies: Restorative Neurology and Neuroscience Vol 22(3-5) 2004, 359-369.
*Hoffman, B. F. (1982). Reversible neurosyphilis presenting as chronic mania: Journal of Clinical Psychiatry Vol 43(8) Aug 1982, 338-339.
*Hopf, H. C., Muller-Forell, W., & Hopf, N. J. (1992). Localization of emotional and volitional facial paresis: Neurology Vol 42(10) Oct 1992, 1918-1923.
*Hummel, F., Celnik, P., Giraux, P., Floel, A., Wu, W.-H., Gerloff, C., et al. (2005). Effects of non-invasive cortical stimulation on skilled motor function in chronic stroke: Brain: A Journal of Neurology Vol 128(3) Mar 2005, 490-499.
*Ince, L. P., Brucker, B. S., & Alba, A. (1978). Conditioned responding of the neurogenic bladder: Psychosomatic Medicine Vol 40(1) Feb 1978, 14-24.
*Ishikawa, T., Hokoishi, K., Mori, T., Maki, N., Komori, K., Ikeda, M., et al. (2004). A Case of General Paresis without Improved Cerebral Blood Flow Following Antisyphilitic Therapy, Resulting in Improvement of Mental Symptoms, Neurological and Neuropsychological Findings: Seishin Igaku (Clinical Psychiatry) Vol 46(7) Jul 2004, 749-752.
*Jacob, A., Cherian, P. J., Radhakrishnan, K., & Sarma, P. S. (2003). Emotional facial paresis in temporal lobe epilepsy: its prevalence and lateralizing value: Seizure Vol 12(1) Jan 2003, 60-64.
*Jacobowsky, B. (1965). General paresis and civilization: Acta Psychiatrica Scandinavica 41(3) 1965, 267-273.
*Jeannet, P.-Y., Marcoz, J.-P., Kuntzer, T., & Roulet-Perez, E. (2008). Isolated facial and bulbar paresis: A persistent manifestation of neonatal myasthenia gravis: Neurology Vol 70(3) Jan 2008, 237-238.
*King, L. J. (2000). The best possible means of benefiting the incurable: Walter Bruetsch and the malaria treatment of paresis: Annals of Clinical Psychiatry Vol 12(4) Dec 2000, 197-203.
*Knopman, D. S., & Rubens, A. B. (1986). The validity of computed tomographic scan findings for the localization of cerebral functions: The relationship between computed tomography and hemiparesis: Archives of Neurology Vol 43(4) Apr 1986, 328-332.
*Kodama, K., Okada, S.-i., Komatsu, N., Yamanouchi, N., Noda, S., Kumakiri, C., et al. (2000). Relationship between MRI findings and prognosis for patients with general paresis: Journal of Neuropsychiatry & Clinical Neurosciences Vol 12(2) Spr 2000, 246-250.
*Krings, T., Topper, R., Willmes, K., Reinges, M. H. T., Gilsbach, J. M., & Thron, A. (2002). Activation in primary and secondary motor areas in patients with CNS neoplasms and weakness: Neurology Vol 58(3) Feb 2002, 381-390.
*Kuzniecky, R., Andermann, F., & Guerrini, R. (1994). Infantile spasms: An early epileptic manifestation in some patients with the congenital bilateral perisylvian syndrome: Journal of Child Neurology Vol 9(4) Oct 1994, 420-423.
*Leewe, A. (1972). Hearing loss and its therapy in children with infantile cerebral paresis: Heilpadagogik Vol 41(3) Sep 1972, 241-249.
*Levyatov, V. M. (1972). A pseudoparalytic variety of epileptic dementia: Zhurnal Nevropatologii i Psikhiatrii imeni S S Korsakova Vol 72(6) 1972, 875-879.
*Lings, S. (1991). Assessing driving capability: A method for individual testing: The significance of paraparesis inferior studied in a controlled experiment: Applied Ergonomics Vol 22(2) Apr 1991, 75-84.
*Lippert-Gruner, M. (2002). Paresis, historical therapy in the perspective of Caelius Aurelianus, with special reference to the use of hydrotherapy in antiquity: Journal of the History of the Neurosciences Vol 11(2) Jun 2002, 105-109.
*Magaret, A. (1942). Parallels in the behavior of schizophrenics, paretics, and pre-senile non-psychotics: The Journal of Abnormal and Social Psychology Vol 37(4) Oct 1942, 511-528.
*Maranhao-Filho, P., do Souto, A. A. D., & Nogueira, J. (2007). Paresia isolada do nervo patetico por compressao da arteria basilar dolicoectasica: Relato de caso: Arquivos de Neuro-Psiquiatria Vol 65(1) Mar 2007, 176-178.
*Martin Ramirez, J., Boenicke, C., & Aksanski, R. (1977). Psychic disorders and paresis in patients with cerebral tumors: Revista de Psicologia General y Aplicada Vol 32(146) May-Jun 1977, 399-408.
*Mrabet, H., Ben Mrad, F. B., Touibi, S., & Mrabet, A. (2006). Presentation of a cavernous angioma with an oculomotor nuclear syndrome: A case report: Revue Neurologique Vol 162(2) Feb 2006, 238-239.
*Mullges, W., Ferbert, A., & Buchner, H. (1991). Transcranial magnetic stimulation in psychogenic pareses: Nervenarzt Vol 62(6) Jun 1991, 349-353.
*Nakamura, R., Taniguchi, R., & Yokochi, R. (1978). Dependence of reaction times on movement patterns in patients with cerebral hemiparesis: Neuropsychologia Vol 16(1) 1978, 121-124.
*Nakanishi, K., Kamei, Y., Nakajima, T., Enomoto, T., Hayakawa, T., Tsukada, K., et al. (2002). Initial symptoms and intelligence prognoses in 8 cases of general paresis: Seishin Igaku (Clinical Psychiatry) Vol 44(12) Dec 2002, 1287-1293.
*Neville, B. (1997). The Worster-Drought syndrome: A severe test of paediatric neurodisability services? : Developmental Medicine & Child Neurology Vol 39(11) Nov 1997, 782-784.
*Nitrini, R. (2005). The Cure of One of the Most Frequent Types of Dementia: A Historical Parallel: Alzheimer Disease & Associated Disorders Vol 19(3) Jul-Sep 2005, 156-158.
*No authorship, i. (1913). Review of General Paresis: Psychological Bulletin Vol 10(6) Jun 1913, 249.
*Page, S. J. (2001). Mental practice: A promising restorative technique in stroke rehabilitation: Topics in Stroke Rehabilitation Vol 8(3) Fal 2001, 54-63.
*Page, S. J., Levine, P., Sisto, S., & Johnston, M. V. (2001). A randomized efficacy and feasibility study of imagery in acute stroke: Clinical Rehabilitation Vol 15(3) 2001, 233-240.
*Phoncharoensri, D., Witoonpanich, R., Tunlayadechanont, S., & Laothamatas, J. (2004). Confusion and paraparesis: Lancet Vol 363(9425) Jun 2004, 1-3.
*Pieterse, M. E., Seydel, E. R., DeVries, H., Mudde, A. N., & Kok, G. J. (2001). Effectiveness of a minimal contact smoking cessation program for Dutch general practitioners: A randomized controlled trial: Preventive Medicine: An International Journal Devoted to Practice and Theory Vol 32(2) Feb 2001, 182-190.
*Pinho e Melo, T., & Bogousslavsky, J. (2001). Hemiparesis and other types of motor weakness. New York, NY: Cambridge University Press.
*Platz, T. (2004). Impairment-oriented Training (IOT)--Scientific concept and evidence-based treatment strategies: Restorative Neurology and Neuroscience Vol 22(3-5) 2004, 301-315.
*Platz, T., Kim, I. H., Engel, U., Pinkowski, C., Eickhof, C., & Kutzner, M. (2005). Amphetamine fails to facilitate motor performance and to enhance motor recovery among stroke patients with mild arm paresis: Interim analysis and termination of a double blind, randomised, placebo-controlled trial: Restorative Neurology and Neuroscience Vol 23(5-6) 2005, 271-280.
*Platz, T., Kim, I. H., Pintschovius, H., Winter, T., Kieselbach, A., Villringer, K., et al. (2000). Multimodal EEG analysis in man suggests impairment-specific changes in movement-related electric brain activity after stroke: Brain: A Journal of Neurology Vol 123(12) Dec 2000, 2475-2490.
*Popkowska, N. (1975). A case of general paresis in a child: Psychiatria Polska Vol 9(1) Jan-Feb 1975, 85-88.
*Rabiner, C. J. (1985). An unusual case of depression: Psychiatric Hospital Vol 16(1) Win 1985, 11-13.
*Robinson, J. L., Mandel, S., & Sataloff, R. T. (2005). Objective Voice Measures in Nonsinging Patients With Unilateral Superior Laryngeal Nerve Paresis: Journal of Voice Vol 19(4) Dec 2005, 665-667.
*Roelofs, K., van Galen, G. P., Eling, P., Keijsers, G. P. J., & Hoogduin, C. A. L. (2003). Endogenous and Exogenous Attention in Patients with Conversion Paresis: Cognitive Neuropsychology Vol 20(8) Dec 2003, 733-745.
*Rola, J. (1992). Mathematical ability profile of children with early cerebral paresis: Psychologia Wychowawcza Vol 35(1) Jan-Feb 1992, 58-67.
*Schain, R. (2001). The legend of Nietzcshe's syphilis. Westport, CT: Greenwood Press/Greenwood Publishing Group.
*Southard, E. E., & Tepper, A. S. (1913). The possible correlations between delusions and cortex lesions in general paresis: The Journal of Abnormal Psychology Vol 8(4) Oct-Nov 1913, 259-275.
*Sterr, A., & Freivogel, S. (2003). Motor-improvement following intensive training in low-functioning chronic hemiparesis: Neurology Vol 61(6) Sep 2003, 842-844.
*Sterr, A., Freivogel, S., & Voss, A. (2002). Exploring a repetitive training regime for upper limb hemiparesis in an in-patient setting: A report on three case studies: Brain Injury Vol 16(12) Dec 2002, 1093-1107.
*Stolyarov, L. G., Kadykov, A. S., & Tkacheva, G. R. (1983). A system for evaluating the motor functions of patients with post-stroke paresis: Soviet Neurology & Psychiatry Vol 16(3) Fal 1983, 34-41.
*Teive, H. A. G. (2006). "Basilar impression associated with impacted cisterna magna, spastic paraparesis and distress of balance:" Comment: Arquivos de Neuro-Psiquiatria Vol 64(4) Dec 2006, 1053.
*Terada, S., Kemori, N., Ishizu, H., Kuroda, S., Kohira, I., & Abe, K. (2000). A case of general paresis with right hemisphere dominant brain atrophy and decreased cerebral blood flow, showing psychiatric symptoms at the beginning of antibiotic therapy: Seishin Igaku (Clinical Psychiatry) Vol 42(8) 2000, 835-839.
*Trier Andersen, O. (1986). A system for quantitative assessment of dyscoordination and tremor: Acta Neurologica Scandinavica Vol 73(3) Mar 1986, 291-294.
*Venkoba Rao, A., Ranganathan, P. S., & Natarajan, M. (1972). General paresis in the psychiatric department of a general hospital in India: British Journal of Psychiatry Vol 121(561) Aug 1972, 143-146.
*Vodovnik, L., Roskar, E., Pajntar, M., & Gros, N. (1979). Modeling the voluntary hypnosis-induced motor performance of hemiparetic patients: IEEE Transactions on Systems, Man, & Cybernetics Vol 9(12) Dec 1979, 850-855.
*Vroomen, P. C. A. J. (2005). Postictal paresis in focal epilepsies--Incidence, duration, and causes: A video-EEG monitoring study: Neurology Vol 64(3) Feb 2005, 580.
*Zaubi, M. (2006). Precipitating Factors Relating to Onset of Medically Unexplained Paresis and Anesthesia: Meta-Analytic Review: Arab Journal of Psychiatry Vol 17(2) Nov 2006, 185-196.
This page uses Creative Commons Licensed content from Wikipedia (view authors).
Advertisement