The Unknown Sleepy Sickness

You Might Never Wake Up And No One Knows Why

Known as one of the most baffling and forgotten epidemics of the 20th century, Encephalitis Lethargica, also known as ‘sleepy sickness’, swept across the globe in the 1920s.

First categorised and described by neurologist Constatin von Economo in 1917, Encephalitis Lethargica attacks the brain, leaving victims in a catatonic state, unable to speak or move. Between 1915 and 1926, an epidemic of Encephalitis Lethargica spread across the globe, killing nearly a million people, and leaving millions of victims in institutions, frozen inside their immobile and speechless bodies.

Victims of Encephalitis Lethargica would suffer from a high fever, sore throat, headache, lethargy, double vision, delayed physical and mental responses and catatonia. Patients may have also shown signs of abnormal eye movements, Parkinsonism, muscle weakness and pain, tremors, body rigidity, and behavioural changes including psychosis.

In 1927, the epidemic vanished as quickly as it had appeared, becoming known through history as the ‘forgotten plague’. The frightening thing about this disease is not just its deadly nature, but that back in the 1920s, no one knew where it came from, what had caused it, or how to treat it.

Even more frightening is this is still true today, with no known cause or treatment of Encephalitis Lethargica established. Thankfully, since the 1920s epidemic, there has only been reported, isolated cases of Encephalitis Lethargica.

In the 1966, neurologist and writer Oliver Sacks began working with 1920s Encephalitis Lethargica survivors at the chronic care facility Beth Abraham Hospital. There he attempted to help and treat these patients by administering what was then a new drug called L-DOPA. Sacks had heard of the drug being a success in similar cases, and astonishingly, when it was administered to victims of Encephalitis Lethargica, the patients began to respond, ‘awakening’ from their comatose, motionless state that they had been trapped in for decades. After only a few days on the L-DOPA, men and women who had previously been lost in their useless bodies for nearly half a century, took their first steps out of their wheelchairs, danced and sang.

Unfortunately, these amazing results were short lived, with the limitations of the drug’s effectiveness becoming apparent when the patients became overwhelmed by seizures and tics, before reverting back to their catatonic states.

In response to this experiment with the L-DOPA drug in Encephalitis Lethargia patients, Sacks wrote the book ‘Awakenings’, realised in 1973, which was the topic of a 1974 documentary, also called ‘Awakenings’, as well as a play ‘A Kind of Alaska’, by Harold Pinter, and a novel ‘Asleep’, by Molly Caldwell Cross. It was also adapted into an Oscar-nominated film called ‘Awakenings’ in 1990 that starred Robin Williams and Robert De Niro.

Even after the 1920s epidemic, and Oliver Sacks’ 1960s study and experiment, scientists and neurologists today are still in the dark on the causes and successful treatment of Encephalitis Lethargica, which leaves us with the eerie, haunting question: what happens if this disease, this ‘forgotten plague’, returns to an epidemic level?