Lethargic encephalitis

Chapter 3 mentioned the similarity between neuroleptic malignant syndrome and an acute episode of the viral disorder, lethargic encephalitis 

There are many other ways in which neuroleptic drug effects closely mimic those of lethargic encephalitis, as reported during and after World War I (Breggin, 1993). Both the neuroleptics and the viral disease produce mental apathy and indifference. In a 1970 retrospective, Deniker observed, 

It was found that neuroleptics could experimentally reproduce almost all symptoms of lethargic encephalitis. In fact, it would be possible to cause true encephalitis epidemics with the new drugs. 

After an apparent recovery, many of the encephalitis victims later went on to develop severe psychoses and dementia (Abrahamson, 1935 Matheson Commission, 1939). Thus the completion of the parallel between lethargic encephalitis and neuroleptic effects awaited the discovery that in addition to TD, tardive psychosis and tardive dementia could follow the exposure to neuroleptics. 

The parallel between the medication effects and the viral encepha-lopathic effects sounded a warning that similar mechanisms—and hence similar adverse outcomes—were possible. Only a few years after the advent of the neuroleptics, Paulson (1959) raised this concern when he wrote, 

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Breggin, P. R. 1993a, Parallels between neuroleptic effects and lethargic encephalitis the production of dyskinesias and cognitive disorders, Brain Cogn., vol. 23, no. 1, pp. 8-27. 

There is little or nothing about acute NMS to distinguish it from an acute, severe episode of encephalitis, especially lethargic encephalitis (also called von Economo s disease), except for the fact of recent exposure to neuroleptic therapy. I have previously compared neuroleptic toxicity and lethargic encephalitis in detail (Breggin, 1983b, 1993 see also chapter 5). 

Other investigators also noticed comparisons between neuroleptic toxicity and lethargic encephalitis (Brill, 1959 Hunter et al., 1964). Brill (1959) documented that the hardest hit areas in lethargic encephalitis... 

Abrahamson, I. (1935). Lethargic encephalitis. New York privately published. 

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