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February 1934


Author Affiliations

Senior Psychiatrist, Bellevue Hospital NEW YORK

From the Research Department of the Psychiatric Division of Bellevue Hospital.

Arch NeurPsych. 1934;31(2):310-337. doi:10.1001/archneurpsyc.1934.02250020098005

Recent studies in encephalopathia alcoholica by Schilder and myself1 showed five different clinical pictures, depending on whether the most prominent features were: (1) clouding of the consciousness with changing rigidities in the limbs, (2) cerebellar disturbances, (3) catatonia-like condition, (4) prolonged delirium or (5) polyneuritic features. In the clinical study the symptoms associated with cerebral, cerebellar and brain stem disturbances were emphasized, while those associated with lesions of the spinal cord or of the peripehral nerves were mentioned only in passing. Postmortem neuropathologic studies were made in seven of the cases with findings that correlated with the clinical groupings. The lesions always occurred in parts of the central nervous system adjacent to the spinal fluid. It was essentially a reactive, productive, invasive ependymitis of all the ventricular surfaces, and a marginal gliosis of all the surfaces of the brain and brain stem with an underlying proliferative hemorrhagic disturbance of