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[德热里纳 - 鲁西丘脑综合征。绪论]

[The thalamic syndrome of Déjérine-Roussy. Prolegomenon].

作者信息

De Smet Y

出版信息

Rev Neurol (Paris). 1986;142(4):259-66.

PMID:3538284
Abstract

Predicted by Dejerine and Long in 1898 and formally described by Dejerine and Roussy in 1906, the "thalamic syndrome" corrected the wrong hypothesis of a capsular "sensory cross roads" suggested by Charcot after 1873 and supported in France during 25 years. Both established the "persistent frank organic hemianesthesia" (sensory-sensitive for Charcot, pure sensitive for Dejerine), namely that a sensory deficit, still severe after regression of the early hemiplegia, could be due to focal brain damage. At that time such a clinical concept was hardly acceptable because it opposed the classic greek philosophical idea that sensation and movement should not be separated. Moreover, intelligence was at that time looked as a four-stage process including sensation, imagination, intellect and memory. The very first step began with the "sensus communis", an anteroom-like where all the sensations simultaneously perceived were coordinated to ensure mind unity. This "sensus communis" was given many subcortical seats during the following centuries, such as the trigone (Herophilus), the ventricles (Founders of the Church, Soemmering), the pineal body (Descartes), the striate bodies (Willis) and, finally, the thalamus (Todd and Carpenter's "English theory"). The description by Meynert in 1871 of a transcapsular direct "sensory bundle" and the cases reported by Türck in 1859 of a sensory-sensitive hemianesthesia after a posterior capsular lesion (in fact, thalamo-capsulostriate) led Charcot to develop his theory after 1873. Owing to the new staining methods of Weigert and Marchi introduced around 1885, Dejerine showed in 1895 the route of the medial lemniscus and his arrival in the thalamus, which led him to postulate in 1898 a "thalamic syndrome" and later to demonstrate it.

摘要

1898年由德热里纳和朗预测,并于1906年由德热里纳和鲁西正式描述的“丘脑综合征”,纠正了夏科在1873年后提出并在法国流行了25年的关于囊“感觉交叉路口”的错误假说。两人都确立了“持续性完全性器质性偏身感觉缺失”(夏科认为是感觉性的,德热里纳认为是纯感觉性的),即早期偏瘫消退后仍严重的感觉障碍可能是由于局灶性脑损伤所致。当时这样的临床概念很难被接受,因为它与经典的希腊哲学观点相悖,即感觉和运动不应分离。此外,当时智力被视为一个包括感觉、想象、智力和记忆的四阶段过程。第一步始于“共同感觉”,它就像一个前厅,在这里所有同时感知到的感觉被协调起来以确保思维的统一。在接下来的几个世纪里,“共同感觉”被赋予了许多皮质下的位置,比如三角区(希罗菲卢斯)、脑室(教会创始人、泽梅林)、松果体(笛卡尔)、纹状体(威利斯),最后是丘脑(托德和卡彭特的“英国理论”)。1871年迈内尔特对经囊直接“感觉束”的描述以及1859年图尔克报道的后囊病变(实际上是丘脑 - 囊 - 纹状体病变)后出现的感觉性偏身感觉缺失病例,促使夏科在1873年后发展了他的理论。由于1885年左右引入的魏格特和马尔基的新染色方法,德热里纳在1895年展示了内侧丘系的路径及其通向丘脑的过程,这使他在1898年提出了“丘脑综合征”,并随后进行了论证。

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