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zoom RSS ショパンは側頭葉てんかんだった?

<<   作成日時 : 2011/02/01 20:33   >>

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 ポーランドの作曲家・ピアニストのショパンは幻覚に襲われたが、側頭葉てんかんによるものだという研究が発表された。
 1849年に39歳で亡くなったが長いこと呼吸器疾患で病床に臥していた。四肢がはれてひどい頭痛に悩まされていたという。
 正確な死因は不明で、剖検の結果も消失している。肺結核、僧帽弁狭窄、嚢胞性線維症、肺気腫、チャーグ-ストラウス症候群、アレルギー性気管支肺アスペルギルス症などの診断が疑われている。ショパンの父とその姉妹2人が呼吸器疾患に苦しんだため、遺伝性疾患の可能性がある。
 しかし、ショパンは何度か幻覚のエピソードがあり、手紙にもそのエピソードを書いている。
 精神障害や薬物中毒ではなく、側頭葉てんかんによると研究者は推測している。側頭葉てんかんの幻視は、短時間で、定型化され、断片的であり、エピソードの前に心配、恐怖、不眠、抑鬱などの症状を訴えるので、ショパンの症状はすべて当てはまっているという。

----------------------------------------------------
Did Chopin Have Epilepsy?
Epilepsy May Have Triggered Polish Composer Fre'de'ric Chopin's Hallucinations, Researchers Say
http://abcnews.go.com/Health/Wellness/chopin-epilepsy/story?id=12756776

By TODD NEALE, MedPage Today Staff Writer
Jan. 25, 2011

画像The hallucinations of Polish composer and pianist Fre'de'ric Chopin may have been the result of temporal lobe epilepsy, two researchers proposed.

Chopin died in 1849 at age 39 following a life filled with health problems -- including respiratory complaints, nasal blockage, lung infections, coughing and fever -- that would confine him to his bed for long periods of time.

In addition, he developed swollen limbs and severe headaches in the years leading up to his death, according to radiologist Dr. Manuel Va'zquez Caruncho and neurologist Dr. Francisco Bran~as Ferna'ndez of Complexo Hospitalario Xeral-Calde in Lugo, Spain.

Read this story on www.medpagetoday.com.

The exact cause of the composer's death remains unknown, and the results of his autopsy were lost, the Spanish researchers noted online in Medical Humanities.

That uncertainty has fueled speculation about what killed Chopin. A list of proposed diagnoses includes pulmonary tuberculosis, mitral stenosis, cystic fibrosis, pulmonary emphysema, Churg-Strauss syndrome, and allergic bronchopulmonary aspergillosis.

According to Va'zquez Caruncho and Bran~as Ferna'ndez, a genetic disease is considered most likely because Chopin's father and two of his sisters suffered from respiratory complaints throughout their lives as well.

Looking beyond the cause of death, however, the Spanish researchers explored the possible reasons for the hallucinatory episodes Chopin had on several occasions.

One such incident occurred while he played at the home of a wealthy merchant and the musician described it in a letter dated about a year before his death.

"A strange adventure happened to me while I was playing my B flat Sonata for some English friends," Chopin wrote. "I had played the Allegro and the Scherzo more or less correctly and I was about to play the March when, suddenly, I saw emerging from the half-open case of my piano those cursed creatures that had appeared to me on a lugubrious night at the Carthusian monastery [Majorca]. I had to leave for a while in order to recover myself, and after that I continued playing without saying a word."

Hallucinations Suggest Temporal Lobe Epilepsy

Although hallucinations are the hallmark of various psychiatric disorders, according to the authors, Chopin's were generally unlike those associated with psychosis.

The episodes were also likely not the result of toxicity from the drugs he took for his various ailments, such as laudanum.

"Toxic hallucinations can be visual, synesthetic, tactile, or auditory," Va'zquez Caruncho and Bran~as Ferna'ndez explained. "When they are visual the images are usually abstract and preceded by unformed visual sensations. In addition, Chopin experienced hallucinations before he was on frequent medication."

Based on the descriptions of Chopin's episodes, the researchers proposed temporal lobe epilepsy as the underlying cause.

"Temporal lobe epilepsy may produce complex visual hallucinations, but they are usually brief, stereotyped and fragmentary," they wrote.

The authors noted, too, that psychiatric symptoms -- including anxiety, fear, sleeplessness, and depression -- can precede epileptic episodes. Chopin complained of all of those symptoms.

Va'zquez Caruncho and Bran~as Ferna'ndez acknowledged that they "know nothing about his physical neurological state, nor have we imaging or electrophysiology tests that could help us establish a definite diagnosis."

But, they added, "a condition such as that described in this article could easily have been overlooked by Chopin's doctors."

They concluded, "We doubt that another diagnosis added [to] the already numerous list will help us understand the artistic world of Fre'de'ric Chopin," they wrote, "but we do believe that knowing he had this condition could help to separate romanticized legend from reality and shed new light in order to better understand the man and his life."


-----------------------------------------------------
Med Humanities doi:10.1136/jmh.2010.005405

The hallucinations of Fre'de'ric Chopin

1. Manuel Va'zquez Caruncho1,
2. Franciso Bran~as Ferna'ndez2

+ Author Affiliations
1.Servicio de Radiologi'a, Complexo Hospitalario Xeral-Calde, Lugo, Spain
2.Servicio de Neurologi'a, Complexo Hospitalario Xeral-Calde, Lugo, Spain

1. Correspondence to Manuel Va'zquez Caruncho, Servicio de Radiologi'a, Complexo Hospitalario Xeral-Calde, C/ Severo Ochoa, s/n, 27004 Lugo, Spain; manuel.vazquez.caruncho@sergas.es

* Received 10 July 2010
* Accepted 16 November 2010
* Published Online First 24 January 2011

Abstract

Fre'de'ric Chopin is the epitome of the romantic artist; he had a chronic pulmonary disease that ultimately caused his death at the age of 39. An overlooked neurological condition is discussed in this paper. We consider the possibility of a temporal lobe epilepsy, as throughout his life Chopin had hallucinatory episodes, which can accompany seizure disorders.



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