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. 2024 Oct 4;6(5):fcae347. doi: 10.1093/braincomms/fcae347

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© The Author(s) 2024. Published by Oxford University Press on behalf of the Guarantors of Brain.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

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Photographs of patients with encephalitis lethargica. (A) A 20-year-old man with parkinsonism and bradyphrenia. A metal-worker by trade, one of his early symptoms was finding that he was ‘pulled forward’ when trying to pull a lever. (B) A 12-year-old girl in the acute phase of the illness, exhibiting signs of catatonia, including stupor, mutism, staring, waxy flexibility, posturing and catalepsy, her limbs remaining in whichever position they are placed. (C) A 14-year-old boy whose symptoms began with a ‘nervous breakdown’ studying for an exam and developed into parkinsonism and a left hemiparesis, illustrating a circumducting gait. (D) Tremulous handwriting from a 20-year-old man who first presented 6 years earlier when his employer complained he was falling asleep at work.