Oliver Sacks

Effects of levodopa in parkinsonian patients with dementia

The i n d u c t i o n of confusional states, exacerbated dementias, deliria, anxiety states, elations, depressions, and frank psychoses by levodopa has been described by a number of au tho r s . The reported incidence of such psychotic disturbances has varied widely-from 3.5%’ to 55.5%.* Since levodopa has now been released for general use and is being given to large and constantly increasing numbers of parkinsonian patients, it is imperative to determine which patients are especially vulnerable to such disturbances. We have already noted, in p r e 1 i m i n a r y communications, that postenc e p h a l i t i ~ ~ ~ and demented6 patients are especially at risk in this respect, a finding endorsed by the detailed studies of Celesia and Ban.’ The effects of levodopa in postencephalitic patients, and in idiopathic patients with fully intact higher functions, have been described by us else where.*^^ The present communication is specifically concerned with the long-term effects of levodopa in parkinsonian patients with significant impairment of higher function and the ways in which concurrent dementia can modify reactions to levodopa.

Henry Cavendish: an early case of Asperger's syndrome?

Is autism compatible with major creativity or genius? Henry Cavendish (1731–1810) made fundamental advances in many scientific areas, ranging from his discovery of hydrogen to his famous (and remarkably accurate) weighing of the earth and estimation of its density. He showed (by sparking hydrogen and oxygen together) the composition of water; he showed that air was a mixture of nitrogen and oxygen, and also that it contained a minute amount of another substance, which was identified a century later as argon. He discovered specific and latent heats, the cooling and heating of air with expansion and compression, and how the electrical conductivity of solutions varied with their concentration. He discovered eutectic mixtures and supercooling; he discovered an inverse-square law of electrostatic attraction and repulsion, and made exact investigations of what would later be called chemical equivalents. He was the first to realize that a fish, the torpedo, could generate electricity (and a form of electricity quite different from static electricity—electrical currents were unknown at the time). He united extraordinary intuitive powers with great experimental ingenuity and consummate mathematical skill, in a manner perhaps unequalled since Newton. Yet even in his lifetime, his peculiarities were the stuff of legend. He did all his work alone, in complete …

Steroid dementia: A follow-up

We offer a follow-up report on the patient described in our brief communication, “Steroid dementia: an overlooked diagnosis.”1 We described how Mr. K originally developed a mixed picture of psychosis and an Alzheimer-like dementia in the summer of 2001, apparently in consequence of the steroids he was taking. His psychosis promptly cleared when the …