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History of Neurology
February 2004

The Monakow Concept of DiaschisisOrigins and Perspectives

Author Affiliations

From the Department of Psychology, Washington University, St Louis, Mo (Dr Finger); the Department of Neurology, Atrium Medical Center, Heerlen, the Netherlands (Dr Koehler); and the Neurological Department, University Hospital Zurich, Zurich, Switzerland (Dr Jagella).




Copyright 2004 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2004

Arch Neurol. 2004;61(2):283-288. doi:10.1001/archneur.61.2.283

The idea that damage to one part of the nervous system can have effects at a distance was popular during the 19th century. Constantin von Monakow, MD, accepted this idea and blended it with the newly formulated neuron doctrine early in the 20th century to account for ipsilateral paralyses and recovery of function. He called his theory of neural depression caused by loss of inputs to structures tied to the damaged area diaschisis. In this article, we examine the origins of diaschisis and the goals of Monakow. Credit is given to Monakow for drawing needed attention to the dynamics of the nervous system, remote lesion effects, and recovery of function, even though the fine details or specifics of his theory have had a mixed reception.