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October 1940

CHRONIC ENCEPHALITISPathologic Report of a Case with Protracted Somnolence

Author Affiliations


From the Department of Medicine of the University of Chicago; the Morton D. Hull Fund for Medical Research, and the Department of Medicine of Rush Medical College, University of Chicago.

Arch NeurPsych. 1940;44(4):848-866. doi:10.1001/archneurpsyc.1940.02280100150012

Several years ago one of us1 recounted the clinical history of a patient who was of interest because of the extraordinarily long period of somnolence which she had suffered and which, in combination with other signs, had led to a diagnosis of chronic lethargic encephalitis. This patient has since died, and the following pathologic study is reported because the nature and distribution of the changes represent a somewhat unusual and not well known picture of chronic encephalitis and because of the light which the observations cast on the anatomic basis of pathologic sleep.


Clinical Summary.  —In February 1932 Patricia Maguire, aged 26, after several days of progressive drowsiness, sank into five years of almost unbroken sleep. Within twenty-four hours of the onset of her illness there were paresis of the left third cranial nerve and slight narrowing of the right visual field. During the first two