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.

Acute severe memory impairment as a presenting symptom of multiple sclerosis: a clinical case study with 3D double inversion recovery MR imaging.

We present the case of a 21-year-old woman with acute memory impairment. It was initially not recognized as organic in nature. Repeated neuropsychological testing confirmed severely disturbed encoding and recall. Three-dimensional double inversion recovery (3D-DIR) MRI confirmed hippocampal and cortical lesions. Further clinical symptoms, visual evoked potential and MRI suggested a diagnosis of multiple sclerosis (MS). The amnestic syndrome has remained for 5 years. This case illustrates that MS can present with acute cortical symptoms which can be difficult to recognize. The hippocampus can be acutely affected and DIR MRI imaging can help to demonstrate cortical lesions that explain the clinical picture.

[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.

[A meningioma resulting in drastic changes in behavior and life course]. / Een meningeoom als oorzaak van ingrijpende veranderingen in gedrag en levensloop.

Three patients, a 59-year-old woman, a 51-year-old man and a 66-year-old woman presented at a neurological or neurosurgical outpatient clinic after their lives had been drastically affected by behavioural changes. Neither the patients nor their relatives or friends were aware that the behavioural changes may be caused by a medical problem. The cause, a large meningioma, became obvious only after physical symptoms occurred a few years later. The patients recovered after surgery and regretted having made certain decisions with far-reaching repercussions for their lives and families. Behavioural disturbances are seldom due to slowly growing brain tumours, but consultation with a neurologist is recommended if there is any doubt regarding the possibility of somatic causes.