What is it about?
An historic image and accompanying clinical discussion in the public domain of a patient displaying a "fencing posture" serves as a reminder that catalepsy remains relevant in practice today as a nonspecific catatonic symptom that may provide important clinical clues to underlying disorders and serve as a localizing behavioral sign of neuropsychiatric pathology. It also highlights the historic role of neurosyphilis in the development of diagnostic classification systems.
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Why is it important?
The fencing posture has been described after traumatic head injury, as a seizure disorder, in relation to structural lesions of the supplementary motor area of the brain, and historically in people with mental illness some of whom in retrospect may have been suffering from neurosyphilis.
Perspectives
For me, this is a fascinating nexus of historical and contemporary scholarship in both clinical sciences and artistic or cultural representation of mental illness.
Dr. Stanley N. Caroff
University of Pennsylvania
Read the Original
This page is a summary of: En garde! An Historical Note on the Nosology of Catalepsy, Journal of Neuropsychiatry, February 2022, American Psychiatric Association,
DOI: 10.1176/appi.neuropsych.20120304.
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