Anthropological neurology: symptoms and their meanings according to Joseph Prick (1909-1978).

This article describes the life and work of the Dutch neurologist Joseph Prick (1909-1978) and his idea of an anthropological neurology. According to Prick, neurological symptoms should not only be explained from an underlying physico-chemical substrate but also be regarded as meaningful. We present an outline of the historical and philosophical context of his ideas with a focus on the theory of the human body by the French philosopher Maurice Merleau-Ponty (1908-1961) and the concept of anthropology-based medicine developed by Frederik Buytendijk (1887-1974). We give an overview of anthropological neurology as a clinical practice and finally we discuss the value of Prick's approach for clinical neurology today.

From stroboscope to dream machine: a history of flicker-induced hallucinations.

When early neurophysiologists, like William Grey Walter (1910-1977), started using intermittent photic driving in electroencephalography, they were struck by a wide range of visual hallucinations that were reported. In current neuroscience, the phenomenon is used mainly to model hallucinations that are related to altered neuronal activity between the thalamus and the visual cortex, such as the Charles Bonnet syndrome. However, during the psychedelic 1960s, Brion Gysin (1916-1986), a painter and a poet, became interested in the hallucinations and designed his own stroboscope or dream machine, as a means for spiritual enlightenment. This article traces back the history of flicker-induced hallucinations from the early use of stroboscopes in neurophysiology to the dream machine.

[Explaining symptoms: body-object and body-subject]. / Het verklaren van symptomen: lichaam-object en lichaam-subject.

BACKGROUND: Medically unexplained somatic symptoms present a real challenge to modem medicine. They occur frequently and are often chronic. AIM: To discuss the physician's approach to these symptoms. METHOD: We focus on the views of the human body put forward by the French philosopher Merleau-Ponty. His view is illustrated with the help of a case study concerning a patient suffering from borderline personality disorder and complex regional pain syndrome. RESULTS: Merleau-Ponty draws a distinction between body-subject and body-object. By body-object he means the body as determined and predicted by medical science. By body-subject he means the body as we experience it, even before we are aware of it. It is our pre-reflexive body that gives meaning to the world around us. CONCLUSION: We argue that the physician should regard the body not only as an object, but also as a subject, thereby giving renewed attention to the significance of symptoms as an expression of inner experience. In this way symptoms that cannot be explained on a purely physico-chemical level will become more meaningful.

Acute scrotal pain from idiopathic ilioinguinal neuropathy: diagnosis and treatment with EMG-guided nerve block.

Ilioinguinal nerve entrapment presents with a clinical triad of pain in the iliac fossa and inguinal region, sensory abnormalities in the cutaneous distribution of the nerve and tenderness on palpation 2-3 cm medial and below the anterior superior iliac spine. The syndrome poses diagnostic difficulties, as genitofemoral nerve entrapment and non-neurological conditions of the lower abdomen may cause similar pain. We report on a patient with acute groin pain radiating towards the scrotum, caused by ilioinguinal nerve entrapment. The clinical diagnosis was strongly suggested by electromyographic examination, using the monopolar needle as a deep stimulating electrode. Subsequent nerve blockade caused complete relief of symptoms. The technique is described. Future applications for treatment of post-surgical pain are discussed.

Hereditary Pick's disease with the G272V tau mutation shows predominant three-repeat tau pathology.

Frontotemporal dementia and parkinsonism linked to chromosome 17 have been associated with mutations in the microtubule associated protein tau (MAPT or tau) gene. This disorder is characterized by a large spectrum of neuronal and glial tau lesions in different brain regions. Pick bodies were found in a family with hereditary Pick's disease with the G272V mutation and in several families with other tau mutations in exons 9 and 11-13. The biochemical composition of Pick bodies varies between these mutations. Until recently, no detailed biochemical characterization of G272V brain material was done owing to unavailability of fresh frozen brain material. We now report a detailed study using the immunohistochemistry, western blots and electron microscopy of two brains with the G272V mutation that recently became available. Both brains showed severe neuronal loss in the temporal cortex, whereas in the frontal cortex the loss was less; and abundant Pick bodies in the dentate gyrus of the hippocampus, and caudate nucleus. The Pick bodies consisted exclusively of three-repeat (3R) isoforms, as was demonstrated by isoform-specific antibodies and supported by western blot analysis of sarkosyl-insoluble tau. These observations confirm that this family diagnosed with hereditary Pick disease meets all the criteria for this condition, including the presence of Pick bodies that are unphosphorylated at Ser262 and contain twisted filaments with long periodicity consisting only of 3R tau.