Post-Choreic Personality and Neurosis

In the relatively short period which has elapsed since the important findings about personality changes after encephalitis epidemica became known, those findings have been mainly responsible for the enormous advance in our knowledge of the sub-cortical direction of man's emotional and volitional life. This advance in psychopathology subsequently gave rise to the question whether similar sequelae could be found in the personality structure of those who had suffered from other forms of post-infectious encephalopathies. Chorea, which had already offered the puzzling problem of why the rheumatic virus becomes “neurotropic” in certain cases, was amongst the first to be considered, whereas 25 years ago no psychiatrist would have seen a special problem in the personality structure after choreic illness. The first investigations which dealt with entirely new problems in chorea minor were those of E. Straus, (1927), who found thathyperkinetic symptomsare frequently found, either in a generalized form, or as localized tics as sequelae of chorea minor, and of E. Guttmann (1927) and Schulz (1928), who both showed thathereditary predispositionof the brain plays an important role in persons who fall ill with chorea minor. Afollow-up studyof chorea cases with regard to personality development had not been undertaken until the present author's first publication on chorea (1934).