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January 27, 1940


JAMA. 1940;114(4):307-312. doi:10.1001/jama.1940.02810040017004

We are reporting 150 cases of an "encephalopathic syndrome," a condition heretofore almost always fatal, which we believe is caused by nicotinic acid deficiency. This syndrome may occur as the only clinical manifestation of a deficiency disease or it may occur in association with pellagra, polyneuritis due to vitamin B1 deficiency, the oculomotor disturbances of a "central neuritis" or scurvy. The clinical picture of this encephalopathic syndrome is more or less well defined and is characterized by clouding of consciousness, cogwheel rigidities of the extremities and uncontrollable grasping and sucking reflexes.

Bender and Schilder,1 who have described its clinical picture, included this syndrome as one of a group of five which they called collectively "encephalopathia alcoholica." Their classification of the types of encephalopathia alcoholica was related to the most prominent manifestations: (1) clouding of consciousness and changing rigidities, (2) cerebellar symptoms, (3) catatonia, (4) alcoholic delirium and (5)

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