Does The Film Awakenings Accurately Portray The Motor Disorder Encephalitis Lethargica?

880 words - 4 pages

In the early twentieth century, during the end of the First World War, the puzzling illness of Encephalitis Lethargica (EL) swept the world. Millions of people were left to die and others less fortunate continued to live, trapped within their frozen and emotionless bodies. EL causes an inflammation of the brain, targeting the brain stem, which is home to critical motor components like the Basal Ganglia and Substantia Nigra. As it progresses, patients feel rigidity, muscle twitching and tremors similar to Parkinsonism. The current theory on the cause of EL is due to an immune reaction to a streptococcus like bacteria. The film “Awakenings” is a good representation of the physiological effects of the disorder but lacks at depicting the seriousness of psychological issues surrounding EL.
Patients who survived the acute affects of the illness, developed major chronic symptoms in there later years. Such was the case with the main patient in the film, Leonard Lowe, who had the misfortune of acquiring the illness at a young age. The symptoms progressed and left him in a catatonic state along with other survivors. Near the beginning of the film most patients including Leonard are seen motionless in their wheelchairs with a lack of expression on their faces. This accurately resembles the state in which most patients of that disorder are left under. One of the key components damaged in EL is the Basal Ganglia (BG). A major structure in the BG is the Caudate Putamen, which extends into the temporal lobe and amygdala. If the caudate putamen is damaged there is unwanted choreiform (writhing and twitching). Damage to the substantia nigra results in hyperkinetic symptoms seen with EL patients as well as Parkinsonism. Likewise a major projection to the Basal Ganglia comes from the substantia nigra, which acts as rewarding dopaminergic pathway. Parkinson’s disease is caused by a degeneration of this pathway results in an imbalance of output from the basal ganglia to the motor cortex. Talk about his can still use his hands to communicate + catch tennis balls (semi conscious state)
L-Dopa is a common therapy drug to help treat Parkinson’s disease. It is a precursor to the neurotransmitter dopamine. Therefore, it is commonly used to help restore lost dopamine due to the degeneration of the neurons in the substantia nigra. Patients take the drug orally because of its ability to cross the blood-brain-barrier quickly, where it is then converted to dopamine. Dyskinesia is a common noted side effect for many patients receiving L-dopa; do to the rapid increase of dopamine in the brain. This results in uncontrolled...

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