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A history of dystonia: Ancient to modern

Citation

Newby, RE and Thorpe, DE and Kempster, PA and Alty, JE, A history of dystonia: Ancient to modern, Movement Disorders Clinical Practice, 4, (4) pp. 478-485. ISSN 2330-1619 (2017) [Refereed Article]

Copyright Statement

© 2017 The Authors.

DOI: doi:10.1002/mdc3.12493

Abstract

Before 1911, when Hermann Oppenheim introduced the term dystonia, this movement disorder lacked a unifying descriptor. While words like epilepsy, apoplexy, and palsy have had their meanings since antiquity, references to dystonia are much harder to identify in historical documents. Torticollis is an exception, although there is difficulty distinguishing dystonic torticollis from congenital muscular torticollis. There are, nevertheless, possible representations of dystonia in literature and visual art from the pre‐modern world. Eighteenth century systematic nosologists such as Linnaeus, de Sauvages, and Cullen had attempted to classify some spasmodic conditions, including torticollis. But only after Charcot's contributions to clinical neuroscience were the various forms of generalized and focal dystonia clearly delineated. They were categorized as névroses: Charcot's term for conditions without an identifiable neuroanatomical cause. For a time thereafter, psychoanalytic models of dystonia based on Freud's ideas about unconscious conflicts transduced into physical symptoms were ascendant, although there was always a dissenting "organic" school. With the rise of subspecialization in movement disorders during the 1970s, the pendulum swung strongly back toward organic causation. David Marsden's clinical and electrophysiological research on the adult‐onset focal dystonias was particularly important in establishing a physical basis for these disorders. We are still in a period of "living history" of dystonia, with much yet to be understood about pathophysiology. Rigidly dualistic models have crumbled in the face of evidence of electrophysiological and psychopathological overlap between organic and functional dystonia. More flexible biopsychosocial frameworks may address the demand for new diagnostic and therapeutic rationales.

Item Details

Item Type:Refereed Article
Keywords:art, dystonia, history, literature, psychiatry
Research Division:Biomedical and Clinical Sciences
Research Group:Neurosciences
Research Field:Neurology and neuromuscular diseases
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Alty, JE (Associate Professor Jane Alty)
ID Code:133241
Year Published:2017
Deposited By:Wicking Dementia Research and Education Centre
Deposited On:2019-06-19
Last Modified:2022-08-23
Downloads:0

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