Fifteen years history of Parkinson's disease in Spain (1963-1977) . A personal recollection
Giménez-Roldán, S.
Revista de neurologia 49(9): 490-495
2009
ISSN/ISBN: 1576-6578 PMID: 19859891 Document Number: 628352
Parkinson's disease (PD) and movement disorders, currently one of the leading subspecialties among Spanish neurologists, raised only modest interest during the seventies. This is well reflected in Revista de Neurologia, the first journal entirely devoted to Neurology in Spain. Along five years (1973-1977) only 3% out of papers published were devoted to this subject. The functions of the basal ganglia were poorly known. PD was regarded as a disorder of muscular tone, rigidity playing a pivotal role to explain most, if not all, parkinsonian signs. 'Arteriosclerotic parkinsonism', whatever the symptoms might be, was applied to any form of parkinsonism occurring after the age of sixty. Such cases were usually treated by general practitioners, while younger patients were as a rule channeled for stereotactic surgery. Initial experience on levodopa therapy in Spain began around 1970, the drug being initially administered to severely disabled patients after long years of disease course. This, and probably because of the use of somewhat liberal doses of the new drug as well, severe choreiform dyskinesias were particularly common. Unexpectedly, neurologists were newly confronted to unusual, levodopa-related behavioral effects, such as manic behavior and overt hypersexuality, arising interest on non-motor aspects of PD, which had been mostly neglected at the time. Generalized awareness among physicians of PD as a common disorder in a wide age range in the general population, recognition of early signs and, most important, availability of an effective therapy, prompted widespread interest of Spanish neurologists on parkinsonism.