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HISTORICAL NEUROLOGY: David R. Williams, Andrew J. Lees, John R. Wherrett, and John C. Steele J. Clifford Richardson and 50 years of progressive supranuclear palsy Neurology 2008; 70: 566-573 [Abstract] [Full text] [PDF]

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J. Clifford Richardson and 50 years of progressive supranuclear palsy

William J. Weiner   (18 April 2008)

Reply from the authors

John C. Steele, David R. Williams, Andrew J. Lees and John R. Wherrett   (18 April 2008)

J. Clifford Richardson and 50 years of progressive supranuclear palsy 18 April 2008
William J. Weiner, University of Maryland School of Medicine 22 S. Greene Street, N4W46, Baltimore, MD 21201 Send Correspondence to journal: Re: J. Clifford Richardson and 50 years of progressive supranuclear palsy wweiner{at}som.umaryland.edu William J. Weiner	The historical neurology article concerning J. Clifford Richardson and progressive supranuclear palsy (PSP) was a delightful account of the early history of this clinical syndrome. [1] However, the authors’ conclusion that the clinical findings of the described syndrome be designated "Richardson disease" is a step backward for 21st century neurologists. Despite our specialty’s fondness for eponyms, we must keep pace and move forward with the current and future findings from molecular biology. Although I share the desire to honor outstanding clinical neurologists who identified new and different clinical constellations of symptoms and signs in their time, it doesn’t seem to me that we have furthered the education of neurologists in training or advanced our knowledge by promoting these ultimately false classifications. Although far less romantic, it would be more accurate to describe “Richardson Syndrome” and all of the other sub-groupings of PSP by their ultimate—yet to be discovered—genetic classifications. Reference 1. Williams DR, Lees AJ, Wherrett JR, Steele JC. J. Clifford Richardson and 50 years of progressive supranuclear palsy Neurology 2008;70:566-573. Disclosure: The author reports no disclosures.
Reply from the authors 18 April 2008
John C. Steele, Guam Memorial Hospital 515 Alupang Cove, Tamuning, Guam, David R. Williams, Andrew J. Lees and John R. Wherrett Send Correspondence to journal: Re: Reply from the authors jsteele{at}guam.net John C. Steele, et al.	Eponyms are about knowledge. They honor the past, train us in observation, define our practice and enrich the art of medicine. No wonder neurologists have a fondness for them. For example, patients agree that “Parkinson Disease” is a better term for their disease than “the shaking palsy.” And what greater understanding or comfort could “synucleinopathy” bring to a family stricken with it? For such understanding, better it be known as “the shaking palsy”. But best of all is Parkinson disease, a unifying designation for an idiopathic illness that affects many patients and is the research passion of diverse neuroscientists. It is a comfortable term for a dreadful disease, and it permits all scientific disciplines to refine it by their separate observations and interpretation. There is no better designation for this disease at this time. The same is true for diseases experienced by Lou Gehrig and described by Alzheimer and Pick; diseases which also await definition by molecular biologists and geneticists. Fifty years ago, J. Clifford Richardson, a Canadian neurologist in Toronto, recognized a handful of patients with a unique clinical syndrome as British neurologist James Parkinson had identified in London many years before. Richardson’s observation in 1963--coupled with further laboratory findings--have elucidated the clinical syndrome that he first identified as universal and common and its disease may include phenotypes with parkinsonism and freezing. In 1963 Dr. Jerzy Olszewski, a master of neuroanatomy, and I (his resident at the time) identified the unique neuropathology of Richardson syndrome and each of us revealed this clinical-pathological syndrome to our colleagues. [2-4] Olszewski and Richardson agreed that I should be the first author of the paper that we published together in 1964 as progressive supranuclear palsy (PSP). [5] The order of authorship led Andre Barbeau in 1965 to suggest that it also be known as the “Steele-Richardson-Olszewski syndrome” (SRO). [6] That was an honor for me but it missed the point that the original observation that led to our description was by Richardson. By our recent article and this letter, I appreciate the opportunity to suggest that PSP also be known as Richardson disease. I have no doubt Professor Olszewski would agree and understand that we will be equally remembered by history. And I hope others— including Professor Weiner—will also agree and adopt this worthy eponym to honor J. Clifford Richardson’s seminal observation and the knowledge it brings to neurology. References 2. Richardson JC, Steele J, Olszewski J. Supranuclear Ophthalmoplegia, Pseudobulbar Palsy, Nuchal Dystonia and Dementia. A Clinical Report on Eight Cases of “Heterogeneous System Degeneration”. Transactions of the American Neurological Association 1963;8:25-29. 3. Steele J, Richardson JC, Olszewski. Heterogeneous System Degeneration. A clinical report of eight cases. Canadian Neurological Association Program. 1963 :14-15. 4. Olszewski J, Steele J, Richardson JC. Pathological Report on Six Cases of Heterogeneous System Degeneration. J Neuropathol Exp Neurol 1963;23:87-188. 5. Steele JC, Richardson JC, Olszewski J. Progressive supranuclear palsy; a heterogeneous degeneration involving the brain stem, basal ganglia and cerebellum with vertical gaze and pseudobulbar palsy, nuchal dystonia and dementia. Arch Neurol 1964;10:333-359. 6. Barbeau A. Degenerescence plurisystematisee du nevraxe. Syndrome de Steele-Richardson-Olszewski. Un Med Can 1965; 94:15-718. Disclosure: The authors report no disclosures.