La histeria moderna: Parte III trastornos disociativos y conversión / The modern hysteria: Part III dissociative disorders and conversion

La conciencia: característica esencial de esta dimensión de autorepresentación es la interpretación de ciertos estados internos del propio cuerpo como identidad mental y somática. La neurociencia de la conciencia sugiere fuertemente que un nivel de sincronización y unión entre varias partes del cerebro hasta cierto punto refleja la accesibilidad de varios contenidos mentales. Janet (1889) propuso el término désagrégation para referirse a los fenómenos de «no integración¼ y lo situó en el terreno de la anormalidad. Trastornos disociativos: en estos trastornos hay pérdida parcial o completa de la integración normal entre ciertos recuerdos del pasado, la conciencia de la propia identidad, ciertas sensaciones inmediatas y el control de los movimientos corporales (conversión)

The conscience: essential feature of this dimension of self-representation is the interpretation of certain internal states of the body itself as mental and somatic identity. The neuroscience of consciousness strongly suggests that a level of synchronization and union between various parts of the brain to some extent reflects the accessibility of various mental contents. Janet (1889) proposed the term désagrégation to refer to the phenomena of "non integration" and placed it in the terrain of abnormality. Dissociative disorders: in these disorders there is partial or complete loss of normal integration between certain memories of the past, awareness of one's own identity, certain immediate sensations and control of bodily movements (conversion)

Hysteria to conversion disorders: Babinski's contributions / Histeria aos transtornos de conversão: contribuições de Babinski

The main objective of this paper is to present the importance of hysteria on Babinski's oeuvre, and the conceptions of pithiatism from Babinski until the one of conversion disorder. Babinski gave a mental basis for hysteria in the place of Charcot's encephalopatic one, and several important semiotic tools to differentiate organic from hysterical manifestations based on studies from 1893-1917/8. His teachings were spread worldwide, and in Brazil they were also appreciated in the work on hysteria by Antonio Austregesilo, the first Brazilian neurology chairman. The neurobiological basis of hysteria conceived by Charcot is nowadays reappraised, and Babinski's neurosemiological contribution is everlasting. The patients believed to be hysterical, and the two outstanding neurologists, Charcot and Babinski, gave support for the development of the modern neurology.

O objetivo principal deste trabalho é apresentar a importância da histeria na obra de Babinski e a concepção de pitiatismo de Babinski até a de transtorno de conversão. Babinski deu uma base mental para histeria no lugar da encefalopática de Charcot, e várias ferramentas semiológicas importantes para diferenciar manifestações orgânicas de histéricas, com base em estudos de 1893-1917/8. Seus ensinamentos foram disseminados em todo o mundo, e no Brasil eles também foram apreciados no trabalho sobre a histeria por Antonio Austregésilo, o primeiro catedrático da neurologia brasileira. A base neurobiológica da histeria concebida por Charcot é reavaliada hoje em dia, e a contribuição neurosemiológica de Babinski é perene. Os pacientes considerados histéricos e os dois grandes neurologistas, Charcot e Babinski, deram suporte para o desenvolvimento da neurologia moderna.

Una perspectiva neurocientífica sobre la histeria / A neuroscientific approach to hysteria

En la última década, el desarrollo y la puesta en marcha de las modernas técnicas de neuroimagen en el campo de la neurociencia cognitiva han proporcionado una nueva vía de acercamiento al estudio experimental de algunos trastornos mentales. Dentro de esta perspectiva, denominada por algunos autores “neuropsiquiatría cognitiva”, la histeria (o trastorno de conversión, de acuerdo con la clasificación psiquiátrica actual) ha cobrado un amplio protagonismo. De acuerdo con lo anterior, el objetivo del presente trabajo consiste en introducir estudios pioneros basados en una perspectiva neurocientífica de la histeria. Conviene destacar que, si bien estos aportan evidencia significativa sobre algunas de las áreas cerebrales y las disfunciones cognitivas comprometidas en el mencionado trastorno, los resultados obtenidos a la fecha distan aún de ser concluyentes.

In the last decade, the development and implementation of modern neuroimaging techniques in the field of cognitive neuroscience have provided a new way to approach the experimental study of mental disorders. Several authors have proposed the name of “cognitive neuropsychiatry” for this alternative approach. In this context, hysteria (or conversion disorder, according to the current psychiatric classification) has reached a huge protagonism. Therefore, this paper is intended to introduce pioneer studies about hysteria from a neurocientific perspective. It is necessary to highlight that, although these studies offer significant evidence about some of the brain areas and cognitive dysfunctions involved in the above mentioned disorder, results are still far from being conclusive.