Lafora and Trétiakoff: the naming of the inclusion bodies discovered by Lewy / Lafora e Trétiakoff: a denominação dos corpos de inclusão descobertos por Lewy

ABSTRACT Fritz Heinrich Jakob Lewy described, for the first time, in 1912, novel peculiar inclusions in neurons of certain brain nuclei in patients with Paralysis agitans, and compared his finding to the amyloid bodies described by Lafora one year before. Gonzalo Rodriguez Lafora studied one patient with Paralysis agitans, in 1913, and recognized, described, and depicted structures identical to those previously reported by Lewy. He was the first to acknowledge Lewy's finding, and also the first to name such inclusions after the discoverer - cuerpos intracelulares de Lewy (Lewy bodies). Konstantin Nikolaevich Trétiakoff named the inclusions he found in neurons of the substantia nigra of patients with Parkinson's disease as corps de Lewy (Lewy bodies), in 1919. Trétiakoff has unanimously received the credit for the eponym. However, Lafora's earlier description should make him deserving of the authorship of the eponym.

RESUMO Fritz Heinrich Jakob Lewy descreveu pela primeira vez, em 1912, inclusões singulares inéditas em neurônios de certos núcleos do cérebro em casos de Paralysis agitans e comparou seu achado aos corpos amilóides, como descrito por Lafora um ano antes. Gonzalo Rodriguez Lafora estudou um caso de Paralysis agitans, em 1913,e reconheceu, descreveu e representou estruturas idênticas às recentemente relatadas por Lewy. Foi o primeiro a reconhecer o achado de Lewy e também o primeiro a denominar tais inclusões segundo seu descobridor - cuerpos intracelulares de Lewy (corpos de Lewy). Konstantin Nikolaevich Tretiakoff designou as inclusões que encontrou em neurônios da substantia nigra em casos de doença de Parkinson de corps de Lewy (corpos de Lewy), em 1919. Ele recebeu o crédito pelo epônimo de modo unânime. Entretanto, a descrição anterior de Lafora deveria fazê-lo merecedor da autoria do epônimo.

Lewy and his inclusion bodies: Discovery and rejection / Lewy e seus corpos de inclusão: descoberta e rejeição

ABSTRACT Fritz Jacob Heinrich Lewy described the pathology of Paralysis agitans [Parkinson disease] and was the first to identify eosinophilic inclusion bodies in neurons of certain brain nuclei, later known as Lewy bodies, the pathological signature of the Lewy body diseases. In 1912, he published his seminal study, followed soon after by an update paper, and 10 years later, in 1923, by his voluminous book, where he exhaustively described the subject. The publication provided extensive information on the pathology of Paralysis agitans, and the entirely novel finding of eosinophilic inclusion bodies, which would become widely recognized and debated in the future. His discovery was acknowledged by important researchers who even named the structure after him. However, after his last publication on the issue, inexplicably, he never mentioned his histopathological discovery again. Despite several hypotheses, the reasons that led him to neglect (reject) the structure which he so preeminently described have remained elusive.

RESUMO Fritz Jacob Heinrich Lewy descreveu a patologia da Paralysis agitans [doença de Parkinson] e identificou pela primeira vez corpos de inclusão eosinófílos em neurônios de certos núcleos cerebrais, conhecidos mais tarde como corpos de Lewy, assinatura patológica das doenças dos corpos de Lewy. Ele divulgou em 1912 seu trabalho seminal, seguido logo por um artigo de atualização e 10 anos depois, em 1923, seu volumoso livro onde detalhou exaustivamente o assunto. Ali ele trouxe extensa informação sobre a patologia da Paralysis agitans e um achado inteiramente novo, os corpos de inclusão eosinófilos, que seriam valorizados e largamente debatidos no futuro. Seu achado foi reconhecido por importantes pesquisadores que até designaram essa estrutura com seu nome. Entretanto, após sua última publicação sobre o assunto, inexplicavelmente , ele nunca mais mencionou sua descoberta histopatológica. Apesar de diversas hipóteses, a razão que o levou negligenciar (rejeitar) a estrutura, que teve a primazia de descrever, permaneceu desconhecida.

Parkinsonism in the Philippines: Treatment with L-Dopa

This study reports the result of treatment of Parkinsonian patients in the Philippines with L-Dopa. As far as is known, this is the first study to be published in the Philippines Fifteen patients were divided into two: Group A, with 11 patients, includes those who are already under maintenance optimum doses of L-Dopa, and Group B, with 4 patients, includes those whose optimum doses are still in the process of being determined. All three types of Pakinsonism are represented, i.e., post-encephalitic, vascular and idiopathic. Likewise the patients exemplified various stages of disability of the disease Among Group A patients, the duration of L-Dopa treatment ranged from 6-29 weeks, the average being 16.45. The effective oral therapeutic dosage of about 5 grams. This effective dosage produced an improvement that varied between 40-100 percent, with the average being 84 percent Though there is apparent improvement in 3 of the 4 Group B patients it is too early to tell whether or not these improvements will persist or how far they will go With the exception of two, all remaining 13 patients had, at one time or another, one or more of the following side effects: anorexia, nausea, vomiting, postural hypotension, dyskinesia, mental disturbances, cardiac disturbances and skin rashes. Laboratory abnormalities included mild elevation of SGOT, SGPT and serum alkaline phosphatase, and a diffuse slowing of the EEG. However, all side effects, both clinical and laboratory, were transient The results of this study parallel a number of the recent reports in the literature. Nevertheless, it is emphasized that there are still many unanswered questions about this very effective drug, particularly its long term effects. We strongly suggest, therefore, that the physician must assume a number of responsiblities when he uses this drug, including the setting of realistic goals; continuing awareness of the drugs development, especially its limitations; accurate observation, using controlled and quantitative methods; awareness of the supply problem and use of ancillary methods to complement L-Dopa treatment. (Summary)