André Charles, Rios André Rangel
Faculdade de Medicina, Neurologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Instituto de Medicina Social, Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Arq Neuropsiquiatr. 2015 Dec;73(12):1041-3. doi: 10.1590/0004-282X20150164. Epub 2015 Oct 13.
The causes of Friedrich Nietzsche's mental breakdown in early 1889 and of the subsequent slow decay to end-stage dementia along ten years will possibly remain open to debate. The diagnosis of syphilitic dementia paralytica, based only on medical anamnesis and physical examination, was considered indisputable by Otto Binswanger. On the other hand, taking into account recently described diseases, selectively collected evidence lend some support to alternative hypotheses: basal forebrain meningioma, CADASIL, MELAS and frontotemporal dementia.
1889年初弗里德里希·尼采精神崩溃以及随后十年逐渐发展至晚期痴呆的病因，可能仍会引发争议。仅基于病史和体格检查做出的梅毒性麻痹性痴呆诊断，奥托·宾斯万格认为是无可争议的。另一方面，考虑到最近发现的疾病，经选择性收集的证据为一些其他假说提供了一定支持：基底前脑脑膜瘤、伴有皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病（CADASIL）、线粒体脑肌病伴乳酸血症和卒中样发作（MELAS）以及额颞叶痴呆。
