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How does it present?

The term "sleeping sickness", where people seem to fall asleep or freeze whilst eating or working, was first coined to describe two cases in Vienna. However, it can present a wide and sometimes baffling range of symptoms, often with unusual and bizarre behaviour. There are indications that the majority of cases were referred to psychiatrists before being admitted to hospital if the symptoms progressed. It is often mistaken for epilepsy, hysteria or intoxication or a reaction to drugs.

What is the outcome?

Outcome is variable. Some people may make a full recovery; others may retain difficulty with swallowing or double vision. A Parkinsonian-type state may persist. Von Economo wrote "to look at these patients, one would suppose them to be in a state of profound secondary dementia. Emotions are scarcely noticeable in the face but they are mentally intact.".

How can it be treated?

There is no known cure. During the initial stages bodily functions need to be maintained, often involving intensive care therapy. As the condition settles it is a matter of maintaining and hopefully improving function by good physiotherapy, speech therapy and nutrition, as well as providing emotional support.

How may research help?

New and exciting work is being undertaken looking at cellular technology with the ultimate aim of replacing dead cells or rejuvenating damaged cells in the brain. Much of this work is focused on the use of stem cells. Also, work is being undertaken on the effectiveness of physiotherapy and speech therapy for the recovery of functional ability. Both of these approaches have the potential to improve the outcome for patients with encephalitis lethargica.




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