The loss of mental visual imagery between neurology and psychiatry: a critical reexamination of the Charcot and Bernard case (1883)

La perdita dell'immagine mentale visiva tra neurologia e psichiatria: una rivisitazione critica del caso di Charcot e Bernard del 1883

S. Zago*, N. Allegri*, M. Cristoffanini*, M. Porta**, R. Ferrucci ***, A. Priori***

* U.O.C. Neurologia, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Dipartimento di Neuroscienze ed Organi di Senso, Università di Milano; ** Centro Tourette e Malattie Extrapiramidali, IRCCS Ospedale Galeazzi di Milano; *** Centro Clinico per la Neurostimolazione, le Neurotecnologie ed i Disordini del Movimento, Dipartimento di Neuroscienze ed Organi di Senso, Università di Milano

Summary

Objectives

The Charcot and Bernard case of visual imagery, Monsieur X, is a classic case in the history of neuropsychology. Published in 1883, it has been considered the first case of visual imagery loss due to brain injury. Also in recent times a neurological valence has been given to it. However, the presence of analogous cases of loss of visual imagery in the psychiatric field have led us to hypothesize psychogenic origins rather than organic.

Methods

In order to assess the validity of such an inference, we have compared the symptomatology of Monsieur X with that found in cases of loss of visual mental images, both psychiatric and neurological, presented in literature.

Results

The clinical findings show strong assonances of the Monsieur X case with the symptoms manifested over time by the patients with psychogenic loss of visual imagery.

Conclusions

Although Monsieur X’s damage was initially interpreted as neurological, reports of similar symptoms in the psychiatric field lead us to postulate a psychogenic cause for his impairment as well.

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