PRIMARY PARALYSIS AGITANS (PRIMARY ATROPHY OF EFFERENT STRIATAL AND PALLIDAL SYSTEMS)

Abstract

In May, 1916, at a meeting of the American Neurological Association, I¹described a system disease of the paralysis agitans type associated with atrophy of the large efferent projection cells of the corpus striatum. The atrophic changes involved the cells of the globus pallidus the nucleus basalis and the large cells of the caudate nucleus and putamen. These I regarded as anatomically and physiologically related, constituting the efferent system of the corpus striatum, the globus pallidus mechanism. I called the condition progressive atrophy of the globus pallidus (primary atrophy of the efferent pallidal system). One year later, I described²similar atrophic changes in the large efferent cells of the striatum in the presenile form of paralysis agitans. The existence of a primary system disease in this region with selective involvement of nerve cells was a unique opportunity for an interpretation of the functions and symptomatology of the corpus