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The foundation by Jean-Martin Charcot (1825-1893) of the Salpêtrière School in Paris had an influential role in the development of neurology during the late-nineteenth century. The international aura of Charcot attracted neurologists from all parts of the world. We here present the most representative European, American, and Russian young physicians who learned from Charcot during their tutoring or visit in Paris or Charcot's travels outside France. These include neurologists from Great Britain and Ireland, the United States, Germany and Austria, Switzerland, Russia, Italy, Spain, Belgium and the Netherlands, Scandinavia and Finland, Poland, Bohemia, Hungary, and Romania. Particularly emblematic among the renowned foreign scientists who met and/or learned from Charcot were Charles-Edouard Brown-Séquard , who had interactions with Paris University and contributed to the early development of British and American neurological schools; John Hughlings Jackson , who was admired by Charcot and influenced French neurology similarly as Charcot did on British neurology; Silas Weir Mitchell , the pioneer in American neurology; Sigmund Freud , who was trained by Charcot to study patients with hysteria and then, back in Vienna, founded a new discipline called psychoanalysis; Aleksej Yakovlevich Kozhevnikov and almost all the founders of the Russian institutes of neurology who were instructed in Paris; and Georges Marinesco , who established the Romanian school of neurology and did major contributions thanks to his valuable relation with Charcot and French neurology.

Jean-Martin Charcot (1825-1893) is known to have possessed interesting works of art, e.g. Jan Steen's Marriage at Cana . In 1899, his pupil and colleague Henry Meige (1866-1940) wrote that Charcot had been interested in a painting (after a drawing) by Bruegel, named Les Arracheurs de Pierres de Teste . At the time the painting belonged to Charcot's contemporary Ernest Mesnet (1825-1898). When Charcot visited Mesnet, he offered him a considerable amount of money. The owner did not want to sell it, but promised to leave it to Charcot in his will. As Charcot died earlier than Mesnet, the painting went to the latter's heirs. In 1899, it was possessed by dermatologist dr. Paul de Molènes-Mahon (b. 1857). Meige published an article, in which he criticized the quality of the copy. Surgeon Henri Gaudier (1866-1942) wrote about the original painting in the Museum of St. Omer and confirmed Meige's opinion about the copy. I will illustrate the St. Omer painting and describe Meige's and Gaudier's comments by comparing it with the black & white copy in Meige's 1899 article. My study looks at Charcot as a collector of paintings , which is a minimally studied topic. He may have been interested in the Paris Bruegel copy for clinical and medical-historical reasons, rather than on aesthetic grounds.

Objective: To compare the effectiveness of an antishear mattress overlay (ASMO) with a standard ambulance stretcher surface in reducing pressure and shear and increasing patient comfort., Methods: In this randomized, crossover design, adults in three body mass index categories served as their own controls. Pressure/shear sensors were applied to the sacrum, ischial tuberosity, and heel. The stretcher was placed in sequential 0°, 15°, and 30° head-of-bed elevations with and without an ASMO. The ambulance traveled a closed course, achieving 30 mph, with five stops at each head-of-bed elevation. Participants rated discomfort after each series of five runs., Results: Thirty individuals participated. Each participant had 30 runs (15 with an ASMO, 15 without), for a total of 900 trial runs. The peak-to-peak shear difference between support surfaces was -0.03 N, indicating that after adjustment for elevation, sensor location, and body mass index, peak shear levels at baseline (starting pause) were 0.03 N lower for the ASMO than for the standard surface ( P = .02). The peak-to-peak pressure difference between surfaces was -0.16 mm Hg, indicating that prerun peak-to-peak pressure was 0.16 mm Hg lower with the ASMO versus standard surface ( P = .002). The heel received the most pressure and shear. Discomfort score distributions differed between surfaces at 0° ( P = .004) and 30° ( P = .01); the overall score across all elevations was significantly higher with the standard surface than with the ASMO ( P = .046)., Conclusions: The ASMO reduced shear, pressure, and discomfort. During transport, the ambulance team should provide additional heel offloading., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Migraine symptoms were described in ancient Babylonia, and supernatural forces were felt to play a role in etiology and treatment. This changed in the Greco-Roman period, when the (dis)balance of humors was considered in (patho)physiology and treatment based on this. Aretaeus distinguished between cephalalgia, cephalea, and heterocrania. The latter term was changed to hemicrania by Galen. Physicians in the 17th century attributed headache to the meninges, extracranial periost, and cranial blood vessels. As for the pathophysiology, Willis suggested intracranial vasoconstriction with subsequent dilatation. Tissot and Fothergill gave comprehensive descriptions of migraine, including visual symptoms. Symptomatic and idiopathic hemicrania were distinguished in the early 19th century. Vasomotor pathophysiology was scientifically studied in the 1860s, leading to sympathicotonic and angioparalytic theories. Latham combined them, stating the latter follows the first. Ergot was introduced in 1868; ergotamine was isolated in 1918. This led to the vasodilatation theory of migraine (Wolff), the discovery of 5-HT, and later the specific agonists. Aura and cortical spreading depression were studied in the early 1940s and related to spreading oligemia in the 1980s. Subsequently, hyperemia followed by oligemia after CSD was found. After the discovery of CGRP, a new a class of drugs became the subject of clinical studies., (Copyright © 2023 Elsevier B.V. All rights reserved, including those for text and data mining, AI training, and similar technologies.)

In his Recollections (1947), Dutch neuropsychiatrist Cornelis Winkler mentioned his colleague Ada Potter, who made many of the neuroanatomic drawings in his publications. She also made two microscopical brain atlases (of a rabbit and a cat) and participated in endeavors to publish a human brain atlas. Born on East Java (Dutch East Indies), Potter received her M.D. from the University of Amsterdam. She worked with Winkler until his retirement (1926) and then moved to the United States. Subsequently, she went back to East Java, practicing in an insane asylum. In the meantime, she was active in the women's mancipation movement. After a short stay in Geneva, she returned to the Netherlands in 1939. The rabbit and cat atlases (1911 and 1914, respectively) were major projects that served animal experimenters up to the 1980s. They consist of 40 and 35 black-and-white plates, respectively, depicting microscopic fiber and cell structure drawings with extensive legends. In a period in which medical photography had fully developed, they preferred drawings, particularly because neurons in thick microscopical slices can only be seen by continuous focusing. The choice was shared by well-known neuroanatomists, such as Ramon y Cajal, who noted that drawing facilitates analysis and teaches scientists how to see.

In the period between Morgagni's De Sedibus (1761) and Cruveilhier's Anatomie pathologique (1829-1842), six pathology atlases were published, in which neuropathological subjects were discussed and depicted. It was a period of transition in medical, technical, and publishing areas. The first three (by Matthew Baillie, Robert Hooper, and Richard Bright) were mainly atlases derived from pathological museum specimens. They were selective rather than comprehensive. Of the other three (by Jean Cruveilhier, James Hope, and Robert Carswell), most of the observations were made during autopsies. These illustrations required special arrangements so they could be executed during the autopsies. These were available in Paris rather than in London, which is the reason why Hope and Carswell made many of the drawings in France. The plates in these three were color lithographs. Baillie's book contains only figure descriptions. Bright's and Cruveilhier's atlases provide case descriptions. Hooper and Hope provide theoretical texts and figure legends. Carswell's book has 12 theoretical sections, each followed by plates. The relative cost of the atlases varied with the number of plates. Although the authors made use of artists and engravers, several were talented artists themselves. Many common neurological diseases were depicted.

Gerard van Swieten (1700-1772), famous pupil of Professor Herman Boerhaave (1668-1738) of Leiden University and personal physician of Austrian Habsburg Empress Maria Theresa (1717-1780). Herman Boerhaave was a renowned Dutch physician inside and outside Europe in the 18th century. He was not only appointed professor in medicine, chemistry, and botany but also a chancellor of the Leiden University in 1714 and published his well-known Aphorismi de cognoscendis et curandis morbis in 1709. Gerard van Swieten commented upon Boerhaave's aphorisms and demonstrated actual knowledge, less well-known among the medical community, about the pathophysiology of traumatic brain injury which half a century later (19th century) became known as the Monro-Kellie doctrine. Using the original commentaries upon Boerhaave's aphorisms by van Swieten himself, we explored his way of formulating the pathophysiological concept of traumatic brain injury, which still is valid today., (© 2021 The Author(s) Published by S. Karger AG, Basel.)

In this article, we commemorate the centenary of myelography, a neuroradiological procedure that, despite certain disadvantages, significantly contributed to the diagnosis and localization of spinal cord lesions during the 20th century. From the start, the use of myelography was characterized by different views regarding the potential dangers associated with the prolonged exposure of a "foreign body" to the central nervous system. Such differences in attitude resulted in divergent myelography practices; its precise indications, technical performance, and adopted contrast material remaining subject to variability until the procedure were eventually replaced by MRI at the close of the 20th century., (© 2020 The Author(s) Published by S. Karger AG, Basel.)

In this article, we commemorate the centenary of the discovery and clinical implementation of hyperosmolar therapy for the treatment of increased intracranial pressure (ICP). Following the pioneering work of anatomists Weed and McKibben in 1919, the use of hypertonic solutions was soon adopted into clinical practice, even though the preferred hypertonic agent, route of administration, and ideas regarding the physiological mechanism by which it reduced ICP diverged. These divergent conceptions and practices have continued to surround the use of hyperosmolar therapy into present times., (© 2020 The Author(s)Published by S. Karger AG, Basel.)

Objective: The aim of the work was to study the origin of the idea that herpes labialis (HL) in patients with pneumonia and meningitis was believed to be of prognostic importance., Background: HL is caused by a primary infection or reactivation of herpes simplex type I. In the past, it has been related to pneumonia and meningitis; moreover, HL was believed to be of prognostic importance., Methods: A selection of 19th- and 20th-century textbooks and referred articles was consulted. The relation between meningitis and herpes, type of meningitis, and attributed diagnostic and prognostic importance were studied. In addition, the HL-pneumonia association was studied., Results: The Strasbourg physician Charles-Polydore Forget was the first to describe the HL-meningitis association in 1843. Tourdes (1843), Drasche (1859), and Salomon (1864) attributed a favorable prognostic importance to the HL-meningitis relation. In a comprehensive monograph (1866), August Hirsch, although confirming the association, denied the prognostic importance through critical analysis of the data. Few authors attributed a diagnostic importance to the occurrence of HL, suggesting meningococcal meningitis., Conclusions: The HL-meningitis relation, but not the prognostic importance, has been mentioned in most neurological textbooks since then. In contrast to meningitis, in which a prognostic attribution of HL was only a short-lived 19th-century idea, the favorable prognostic importance of HL in pneumonia continued to be described until the 1950s. A possible protective effect of herpesviruses has been found in recent years. One could speculate that the disappearance of the prognostic HL-pneumonia relation could be related to the introduction of antibiotics in the late 1940s., (© 2020 The Author(s) Published by S. Karger AG, Basel.)

Objective: The worldwide increase in the incidence of syphilis necessitates alertness to the occurrence of neurosyphilis. Early recognition of neurosyphilis allows for timely treatment, leading to a better treatment outcome. This retrospective study aims to describe the clinical presentation of neurosyphilis in a recent series of neurosyphilis patients., Method: All patients were included with a new, laboratory confirmed, diagnosis of neurosyphilis in the period 2004-2018. The clinical data were analysed., Results: 34 neurosyphilis patients (1 woman and 33 men) were identified. Age varied from 31-84 years (median age: 44 years). A history of syphilis infection was known for 11 (32%) patients; 12 (35%) patients were HIV seropositive. The distribution of the clinical syndromes was as follows: 16 patients with early neurosyphilis (acute meningitis, meningovasculitis and/or uveitis), 9 patients with late neurosyphilis (General Paralysis of the Insane and/or Tabes Dorsalis), 2 patients with symptoms of both early and late neurosyphilis, 6 patients with asymptomatic neurosyphilis and in 1 patient insufficient data were available to determine a clinical syndrome. Early neurosyphilis was seen in all age categories, late neurosyphilis only occurred in patients > 40 years., Conclusions: Neurosyphilis occurs in adults in all age groups, in men more frequent than in women, often in HIV-infected patients, and can present with a wide range of clinical syndromes. Usually no previous infection with syphilis is known., Competing Interests: Declaration of interest: none, (© 2019 Giovanni Fioriti Editore s.r.l.)

Background: Cluster headache attacks can, in many patients, be successfully treated with oxygen via a non-rebreather mask. In previous studies oxygen at flow rates of both 7 L/min and 12 L/min was shown to be effective. The aim of this study was to compare the effect of 100% oxygen at different flow rates for the treatment of cluster headache attacks., Methods: In a double-blind, randomized, crossover study, oxygen naïve cluster headache patients, treated attacks with oxygen at 7 and 12 L/min. The primary outcome measure was the percentage of attacks after which patients (treating at least 2 attacks/day) were painfree after 15 min, in the first two days of the study. Secondary outcome measures were percentage of successfully treated attacks, percentage of attacks after which patients were painfree, drop in VAS score and patient preference in all treatment periods (14 days)., Results: Ninety-eight patients were enrolled, 70 provided valid data, 56 used both flow rates. These 56 patients recorded 604 attacks, eligible for the primary analysis. An exploratory analysis was conducted using all eligible attacks of 70 patients who provided valid data. We could only include 5 patients, treating 27 attacks on the first two days of the study, for our primary outcome, which did not show a significant difference (p = 0.180). Patients tended to prefer 12 L/min (p = 0.005). Contradicting this result, more patients were painfree using 7 L/min (p = 0.039). There were no differences in side effects or in our other secondary outcome measures. The exploratory analysis showed an odds ratio of being painfree using 12 L/min of 0.73 (95% CI 0.52-1.02) compared to 7 L/min (p = 0.061) as scored on a 5-point scale. The average drop in score on this 5-point scale, however, was equal between groups. Also slightly more patients noticed, no or not much, relief on 7 L/min, and found 12 L/min to be effective in all their attacks., Conclusion: There is lack of evidence to support differences in the effect of oxygen at a flow rate of 12 L/min compared to 7 L/min. More patients were painfree using 7 L/min, but our other outcome measures did not confirm a difference in effect between flow rates. As most patients prefer 12 L/min and treatments were equally safe, this could be used in all patients. It might be more cost-effective, however, to start with 7 L/min and, if ineffective, to switch to 12 L/min., Trial Registration: European Union Clinical Trials Register ( 2012-003648-59 ), registered 1 October 2012. Dutch Trial Register ( NTR3801 ), registered 14 January 2013.

: In this historical study we present an overview of lumbar interbody fusion surgery, which is one of the most commonly performed instrumented spinal fusion surgeries. The present article focuses on the history of lumbar interbody fusion surgery, starting from the foundation which was laid in the 19th and 20th century until today. The development of material and techniques evolved from simple wiring to the combination of transforaminal interbody fusion with polyether ether ketone cages and pedicle screw fixation with poly axial screws. The possibilities of instrumented spinal fusion grew during the past 100 years, and a considerable increase in instrumented spinal surgery was seen over the past decades. Today, gain lies in perfection of techniques and deliberate indication and development of guidelines. Therefore, more standardized studies on instrumented spinal surgery are needed to be done and techniques should be personalized on the patients' specific needs., Level of Evidence: N/A.

In 1941, Denise Louis-Bar described a child with ataxia and telangiectasia in Confinia Neurologica. The following decade led to an expanse in publications about the disorder with concomitant controversy regarding naming of the disease. While ataxia-telangiectasia is the predominant term used for the disease, Louis-Bar syndrome persists in the medical literature. Despite the persistence of this eponym, little is known about Denise Louis-Bar. Archival materials and information provided from Louis-Bar's Belgian colleagues were examined. Louis-Bar's neurologic training was followed by a productive academic career then private practice emphasizing rehabilitation of neurologic disease, demonstrating her diverse abilities and interests., (© 2018 American Academy of Neurology.)

After the gradual introduction of specialties in medicine in the United States during the late-nineteenth and early-twentieth centuries, the American Board of Psychiatry and Neurology (ABPN) was founded in 1934 to provide specialty regulation (training oversight, examination, and certification). The name reflects the combined practice of psychiatry and neurology that was still present at the time. Directors were nominated by the founding organizations: American Psychiatry Association (APA), American Neurological Association (ANA), and the Section of Nervous and Mental Diseases of the American Medical Association (AMA). Many of the early physicians who were certified by the ABPN did so for psychiatry as well as neurology. Neurologist Walter Freeman and psychiatrist Adolph Meyer played important roles in the ABPN during the early days. Following the founding of the AAN in 1948, neurological practitioners believed the AAN would better represent them in the ABPN. At first the ANA appointed AAN members to the ANA Council; but after 1972, the AAN could directly nominate directors for the ABPN. Despite this situation, the AAN had an important influence in the ABPN from its start, as is shown by the fact that all of the key organizational leaders responsible for founding the AAN-the "Four Horsemen" (Abraham B. Baker, Russell N. DeJong, Francis M. Forster, and Adolph L. Sahs-served as directors of the ABPN in the period 1951-1967. The Horsemen were able to change both examination practices that became more searching and expansive, and the basic disciplines that needed to be studied in detail.

With few exceptions, neurology in Europe as well as in the United States emerged from internal medicine and psychiatry, and neurology and psychiatry in particular have long remained connected in clinical practice and teaching. When the American Board of Psychiatry and Neurology (ABPN, 1934) and the American Academy of Neurology (AAN, 1948) were founded, the emancipation of neurology as an independent specialty was still evolving. During the First International Neurological Congress (Berne, Switzerland, in September 1931), a special conference was organized on the "Relation of Neurology to General Medicine and Psychiatry in Universities and Hospitals of the Various Countries," at which representatives from several countries described the situation in their countries. Their statements were made around the time of the founding of the ABPN and not long before that of the AAN. They show that neurology in most countries was still struggling to become independent and only in a few cities flowered as an independent specialty. In the second part of this article, specialist regulation (training, examination, and certification) in European countries (Germany, France, England, and The Netherlands) will be compared to that of the ABPN. It appears that Germany was among the early countries where this occurred, following the Bremen Ärztetag (physicians day) in 1924. Comparable to the American situation, it was professionally controlled, in contrast to the French state certification, which occurred later. The British specialist regulation was much later and more complicated.

In 1934, Gabrielle Lévy died at the age of 48. She became well known for an article she published on a hereditary polyneuropathy in cooperation with Gustav Roussy, resulting in the eponym Roussy-Lévy syndrome. Not much is known about this extraordinary neurologist/neuropathologist. Her family declared that she died from the disease she was studying. She was a pupil of Pierre Marie, with whom she worked at the Salpêtrière in Paris and wrote on war neurology. In cooperation with Marie, she published a number of articles on postencephalitic syndromes, which also became the subject of her 1922 thesis. Three years later, she became associate physician at the Paul-Brousse Hospital in Paris, where the study of brain tumors became one of the subjects of her scientific work. Remarkably, Lévy was first author in a few of her many articles, although Roussy confirmed that she often initiated the study and even wrote the main part. In this article her career is considered in the context of the struggle of women physicians to improve their position during the early-twentieth century. She probably died from a brain tumor or a postencephalitic syndrome.

We commemorate the centenary of Constantin von Economo's description of encephalitis lethargica, a mysterious disease that had a significant effect on 20th-century neuroscience. In the acute phase, encephalitis lethargica was marked by intractable somnolence, which von Economo attributed to lesions in the diencephalon, thereby paving the way for future efforts to localize the regulation of sleep in the subcortical brain. At the same time, neuropathologic findings in postencephalitic parkinsonism affirmed the role of the substantia nigra in the pathophysiology of parkinsonism. The occurrence of psychiatric symptoms in patients with encephalitis lethargica-such as mood disorders, obsessive-compulsive behavior, and bradyphrenia-drew attention to the organic basis of mental illness., (© 2018 American Academy of Neurology.)

This chapter is concerned with ideas on the function, structure, and pathology that shaped our present knowledge of the cerebellum. One of the main themes in its early history is its localization subtentorially, leading to misattributions due to clinical observations in trauma and lesion experiments that caused collateral damage to the brainstem. Improvement of techniques led to the insight that it plays a role in movement control (Rolando) or coordination (Flourens). Purkinje initiated the histology of the cerebellar cortex in 1837. Luciani's experiments in 1891 led him to conclude that the cerebellum has a tonic facilitating effect on central structures. Cajal identified the elements of the cortex and their circuitry (1888-1891). The inhibitory nature of the interneurons and the Purkinje cells, and the excitatory connections of the mossy and climbing afferents and the granule cells were established much later by Eccles and Ito. A functional localization for the coordinating action of the cerebellum of the motor system, based on local expansion of the folial chains, was devised by Bolk in 1906. Babinski and Holmes contributed to anatomoclinical insights. Magnus and coworkers showed the cerebellum does not play an essential role in body posture. The heterogeneity of the Purkinje cells with respect to their connections and histochemistry found its expression in the zonal organization of the cerebellar cortex. The roots of modern developments, like cerebellar learning and its involvement in cognition and emotion, can be traced to the theories of Marr and Albus and the pioneering work of the Leiners and Dow., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Head tremor may be observed in the presence of cervical dystonia and sometimes coexists with headache. We wished to investigate the presence of headache in dystonic head tremor., Methods: We studied the files of 19 patients from our outpatient clinic (1997-2017) with dystonic head tremor and assessed the co-occurrence of headache. We also performed a literature search of the topic., Results: Cervicogenic headache was present in nearly 37% of patients with dystonic head tremor. More than 85% of our patients presented with a "no-no" head tremor., Discussion: Headache is common in dystonic head tremor. Cervicogenic headache seems to be more frequent in patients with dystonic head tremor than in the general population. Future studies should compare the presence of cervicogenic headache in essential head tremor patients with that in patients suffering from dystonic head tremor., Competing Interests: Funding: None. Conflicts of Interest: The authors report no conflict of interest. Ethics Statement: This study was reviewed by the authors’ institutional ethics committee and was considered exempted from further review.

Trigeminal neuralgia (TN) associated with multiple sclerosis (MS) was first described in Lehrbuch der Nervenkrankheiten für Ärzte und Studirende in 1894 by Hermann Oppenheim, including a pathologic description of trigeminal root entry zone demyelination. Early English-language translations in 1900 and 1904 did not so explicitly state this association compared with the German editions. The 1911 English-language translation described a more direct association. Other later descriptions were clinical with few pathologic reports, often referencing Oppenheim but citing the 1905 German or 1911 English editions of Lehrbuch. This discrepancy in part may be due to the translation differences of the original text.