CEREBRAL METABOLIC DISTURBANCE AND DELIRIUM IN PERNICIOUS ANEMIA

Abstract

IT IS THE purpose of this paper to discuss the disturbance in cerebral function which occurs in pernicious anemia patients. This aspect of the disease process, while noted since the earliest descriptions of the disease, has remained poorly understood because of the lack of tools for proper study of such cerebral processes. HISTORICAL REVIEW In his classical description of pernicious anemia in 1849, Addison¹ may have recognized disturbance in cerebral function in the disease process, for he wrote as follows: Its approach is first indicated by a certain amount of languor and restlessness, to which presently succeed a manifest paleness of countenance, loss of muscular strength, general relaxation or feebleness of the whole frame, and indisposition to, or incapacity for, bodily or mental exertion. Lichtheim² in 1887 first called attention to neurodegenerative changes in pernicious anemia and ascribed them to some blood-circulating toxin. In a poorly received paper,