Margaret A was one of the last recorded individuals to contract encephalitis lethargica. Often these were the same symptoms that had originally presented, but sometimes a severe and unusual form of Parkinson’s disease emerged instead, as was the case for Margaret A, whose story Sacks tells. After a period of recovery - brief in some patients, years-long in others - symptoms would suddenly return. Most disturbing, however, was the post-viral syndrome associated with this disease. Its distinctive mark was a kind of sleeping sickness, interrupted in some by agitation and insomnia. Apparently caused by an enterovirus (a type of RNA virus that usually lives in the gastrointestinal tract), encephalitis lethargica was described by Sacks as a “hydra with a thousand heads” on account of the unpredictable and complex ways in which it would manifest. Readers of writer-neurologist Oliver Sacks will be reminded of the encephalitis lethargica epidemic he describes in his book Awakenings, and the strange post-viral syndrome it left in its wake.īetween 19, encephalitis lethargica spread swiftly across the world, killing half a million people before vanishing almost overnight. Some days were better than others, but ever since her mild bout of Covid-19 eight months ago, Mrs S had forgotten what it felt like to be herself.Ĭases such as that of Mrs S - where an initial viral infection appears to trigger another prolonged period of illness - are not unprecedented. Unable to work as a result of these symptoms, she was on indefinite sick leave, filled with anxiety about her precarious employment status.
She was experiencing heart palpitations and breathlessness after minor exertions, and most of the time these episodes were accompanied by a ringing in her ears. She struggled to keep track of conversations and had gradually begun avoiding social interaction. Her memory was patchy and she was terribly tired all the time. She described feeling foggy and unable to concentrate, very unlike her usual self. It was clear that she was in great distress.
It was following her third visit to the pulmonologist, and a neurological examination, that Mrs S came to the Long Covid Clinic at Groote Schuur Hospital for neuropsychological assessment. © Copyright (c) Daily Maverick, All Rights Reserved Given the long history of gender bias in the medical profession, one cannot help but wonder whether this low-hanging fruit would have been the go-to diagnosis had most of these patients been male. That depression and anxiety are high on the list of Long Covid symptoms is particularly problematic for women, who were often told that their symptoms were psychogenic in nature. Long Covid is showing up in much higher proportions in women compared to men.
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