THE BRAIN-STEM LESIONS IN PARKINSONISM

Abstract

In 19 cases of idiopathic paralysis agitans, 10 cases of parkinsonism with a history of encephalitis, and 5 cases of parkinsonism of uncertain etiology, the pigmented cells of the brain stem, particularly those in the substantia nigra and the locus caeruleus, were examined. They showed (1) saccular distention by lipochrome granules with lack of Nissel granules, melanin and nucleus, (2) vacuolation, (3) binucleated condition (rare), (4) Lewy''s spherical concentric hyaline inclusions, and (5) neurofibrillary tangles without senile plaques. The 1st 3 phenomena were observed principally in the post-encephalitic cases. There was scattering of the remainder of the findings among the various types of cases.