Hysterical chorea: Report of an outbreak and movie documentation by Arthur Van Gehuchten (1861-1914).
Psychogenic movement disorders remain a frequent and important clinical problem. First described in the Middle Ages, the dancing mania is considered to be one form of mass hysteria characterized by outbreaks of collective movement disorders. Patients may exhibit a wide variety of movement and gait disturbances, including tremulousness, jerks, or convulsions, usually with a sudden onset. Arthur Van Gehuchten (1861-1914), a distinguished Belgian neuroanatomist and neurologist, reported an outbreak of sudden involuntary movements in 13 adolescent girls residing in an orphanage. The description is to be found in his book Les Maladies nerveuses, completed before 1914 and published posthumously in 1920. The chapter is illustrated with sequential photographs of a girl exhibiting a peculiar gait, which is descriptively referred to as "chorée salutatoire" (saluting chorea). The original film with these pictures has been retrieved and is presented here together with a very similar film excerpt also found in Van Gehuchten's film collection. Van Gehuchten's movie documentation of a psychogenic movement disorder--labeled chorea but which should probably be considered as dystonia according to contemporary classification--appears to be unique. This report illustrates the tremendous value of moving pictures in recording and analyzing movement disorders.