Hitlers Nervenleiden - Differentialdiagnose des Parkinson-Syndroms

Abstract

This paper deals with the differential diagnosis of Hitler's Parkinsonian syndrome based upon our recently published results of an analysis of Hitler's motor functions in German news-reels, upon archived materials with notes and comments of Hitler's doctors, various memories, and our own interrogations of eye-witnesses of Hitler's nearest entourage. According to these sources, Hitler's Parkinsonian syndrome developing since mid-1941 cannot be attributed to any of the symptomatic forms of Parkinsonism. In light of family history, age of manifestation and clinical features the assumption of idiopathic Parkinson's disease seems somewhat more plausible than that of postencephalitic Parkinsonism; the genetic variant is less probable. Hitler's neurological pathography is further analysed in respect to an abuse with "Antigas pills" and to some statements in the literature presuming an amphetamine-dependence, a syphilitic manifestation, an epileptic seizure in 1932, and a tremor already present in 1923.

Berlin Bowel Bothers: Might Adolf Hitler’s Gut Problems Have Been Parkinson-Related?

“…The possibility of postencephalitic parkinsonism has been suggested as well [5, 12], based upon the supposed occurrence of an encephalitic episode in childhood or early adulthood, as well as reports later in his life of oculogyric crises, dystonic facial spasms, palilalia, autonomic dysfunction, and behavioural abnormalities. However, after analysis of newsreel footage, medical notes, and accounts of contemporaries, neuropsychiatrist Ellen Gibbels found either no reliable evidence of these symptoms or provided alternative explanations for them [5, 14]. In addition, most of those affected by encephalitis lethargica had their acute symptoms between 1918 and 1924 [15], by which time Hitler was well in his adulthood.…”

“…Retrospective explanations given for Hitler’s gastrointestinal symptoms include functional bowel disorder [5], irritable bowel syndrome [2, 6, 7], and gastritis/peptic ulcer [8]. Within Hitler’s medical team, physicians disagreed on the diagnosis.…”

Adolf Hitler and his parkinsonism

“…He focused on Lieberman's[ 2 ] suggestion that Hitler had suffered from postencephalitic parkinsonism, a hypothesis previously put forward by Recktenwald. [ 3 ] However, other authors, analyzing German newsreels and other sources, have come to the conclusion that Hitler rather suffered from idiopathic Parkinson's disease,[ 4 5 6 7 ] indicated by rest tremor and hypokinesia with onset on the left side, followed by disorders of gait and posture, and a significantly progressive course from 1941 which was equivalent to Hoehn and Yahr stage II. [ 6 7 ] Unfortunately, neither Lieberman nor Bhattacharyya did refer to the excellent retrospective mobility analysis by Gibbels, which is based on 83 German newsreel editions between 1940 and 1945 and is supplemented by a large number of detailed written and personal communications by eye witnesses of Hitler's nearest entourage.…”

“…[ 3 ] However, other authors, analyzing German newsreels and other sources, have come to the conclusion that Hitler rather suffered from idiopathic Parkinson's disease,[ 4 5 6 7 ] indicated by rest tremor and hypokinesia with onset on the left side, followed by disorders of gait and posture, and a significantly progressive course from 1941 which was equivalent to Hoehn and Yahr stage II. [ 6 7 ] Unfortunately, neither Lieberman nor Bhattacharyya did refer to the excellent retrospective mobility analysis by Gibbels, which is based on 83 German newsreel editions between 1940 and 1945 and is supplemented by a large number of detailed written and personal communications by eye witnesses of Hitler's nearest entourage. [ 6 7 ] In addition to the tremor already present in 1923 and an epileptic seizure in 1932, this excellent analysis reports some additional interesting phenomena, for example, paradox kinesia,[ 8 ] occasional sialorrhea, speech disorders, micrography, fluctuations, and postural instability (in late disease stages) that are known to be characteristic of parkinsonism, whereas there are no definite historical data for von Economo's encephalitis in 1918 as suggested by Lieberman.…”

“…[ 6 7 ] Unfortunately, neither Lieberman nor Bhattacharyya did refer to the excellent retrospective mobility analysis by Gibbels, which is based on 83 German newsreel editions between 1940 and 1945 and is supplemented by a large number of detailed written and personal communications by eye witnesses of Hitler's nearest entourage. [ 6 7 ] In addition to the tremor already present in 1923 and an epileptic seizure in 1932, this excellent analysis reports some additional interesting phenomena, for example, paradox kinesia,[ 8 ] occasional sialorrhea, speech disorders, micrography, fluctuations, and postural instability (in late disease stages) that are known to be characteristic of parkinsonism, whereas there are no definite historical data for von Economo's encephalitis in 1918 as suggested by Lieberman. [ 6 7 ] Since no postmortem examination of Hitler's brain is available to clarify the type of his unequivocal clinical parkinsonism, Bhattacharyya should have given reference to a number of important previous papers before trying to retrospectively classify Hitler's parkinsonian syndrome.…”