is an atypical form of
Encephalitis .
Encephalitis Lethargica, also known as sleeping sickness (though different from the
Sleeping Sickness transmitted by the
Tsetse Fly ), is a devastating illness that swept the world in the 1920's and then, vanished as soon as it had appeared. Encephalitis Lethargica attacks the brain, leaving some victims like living statues, speechless and motionless. It is as if the victims go to sleep and do not wake up.
Between
1917 and
1928 , an
Epidemic of encephalitis lethargica spread throughout the world, but no recurrence of the epidemic has since been reported, though isolated cases continue to occur. During the outbreak, over a million died, and some were left frozen inside their useless bodies, in institutions.
It is characterized by high
Fever ,
Headache ,
Double Vision , delayed physical and mental response, sleep inversion, catatonia and
Lethargy . In acute cases, patients may enter
Coma . Patients may also experience abnormal
Eye movements, parkinsonism, upper body weakness, muscular pains, tremors, neck rigidity, and behavioral changes including
Psychosis .
Postencephalitic
Parkinson's Disease may develop after a bout of encephalitis, sometimes as long as a year after the illness.
The cause of encephalitis lethargica is not yet known for certain, but on the basis of research by
British doctors
Russell Dale and
Andrew Church , the disease is now thought to be due to a massive
Immune Reaction to an infection by the
Streptococcus -like
Bacterium ,
Diplococcus . There is also some evidence of an
Autoimmune origin with antibodies (IgG) from patients with EL binding to neurones in the basal ganglia and mid-brain. It had been hypothesised that encephalitis lethargica, Sydenham's chorea and PANDAS are mediated by the same post-streptococcal immune response.
Treatment for encephalitis lethargica in the early stages is patient stabilisation, which may be very difficult. There is little evidence so far of a consistent effective treatment for the initial stages, though one patient who was given steroids initially has so far made a good recovery. Other patients have been less fortunate, and the disease then becomes progressive, with evidence of brain damage similar to Parkinson's disease. Treatment is then symptomatic.
Levodopa (
L-Dopa ) and other antiparkinson drugs often produce dramatic responses. However in most of the patients who were given L-Dopa in the 1960s, the amelioration of the disease was short lived.
The course of encephalitis lethargica varies depending upon complications or accompanying disorders.
The discovery that levodopa could produce some amelioration of the symptoms was described in the book ''
Awakenings '' by
Oliver Sacks in
1973 , which was made into a film starring
Robin Williams and
Robert De Niro in
1990 . The book was used by
Harold Pinter as the basis of his one-act play
A Kind Of Alaska , performed in
1982 starring
Judi Dench .
The encephalitis lethargica epidemic of
1917 -
1928 has also appeared in comic book literature in
Neil Gaiman 's
Sandman graphic novels, where in the very first story, in
1987 , he ascribes the "sleeping sickness" to
Morpheus ' imprisonment. Finally, progressive metal band
Dream Theater appear to use the story to form the basis of the second part of the title track of their
2005 album ''
Octavarium ''.
