Clinical Picture and Problems in Terminology

Abstract

The clinical picture of the apallic syndrome was occasionally described in casuistic studies at the end of the nineteenth century. No special attention was given to the clinical picture, and it was described in a rather incidental way. The first description was probably given by Rosenblath (1899), in which a 15-year-old tightrope walker, after toppling from a high wire, fell immediately into a coma and developed stretch cramps. After 2 weeks the patient became strangely awake and this state did not change until the death of the boy 8 months after the accident. It was not until 1940 when Kretschmer—based on his own clinical observations but without knowledge of the older descriptions—recognized the particular importance of the symptom complex. He called it apallic, since in his opinion the condition occurs as a result of extensive disturbances of the pallium in its entire functioning.