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Título

FRIEDRICH NIETZSCHE COLLAPSE: NEUROSYPHILIS OR FRONTOTEMPORAL DEMENTIA?

Resumo

Introduction: Friedrich Nietzsche was a German philosopher who influenced all Western philosophy during the 19th century. His death occurred in 1900, but it all started with a psychotic episode called “Turin Collapse” in 1899. In this episode, Nietzsche embraced the neck of a horse that was being whipped, unconsciously reproducing a scene from the book “Crime and Punishment” by Dostoevsky. After that, he was declining physically and mentally, dying a year after this episode. After several attempts at diagnosis, the main hypothesis is that he had neurosyphilis, a disease that can cause dementia in a more advanced stage of syphilis. However, new diagnoses have recently been raised such as Frontotemporal Dementia (FTD). Objective: To raise questions about the diagnosis of Nietzsche's death. Methods: Critical and objective analysis of Nietzsche's death and the new diagnoses suggested, based on a narrative review of the literature. Results: In 1889, Nietzsche was admitted to a psychiatric hospital in Basel, with loss of cognitive abilities, including language and episodes of aggression and disinhibition. Due to this, the philosopher was diagnosed with "General Paralysis of the Insane” (GPI), the parenchymal form of neurosyphilis. Symptomatic neurosyphilis can be divided into two main types: meningovascular and parenchymal, the latter being the most similar to Nietzsche's condition, starting with mood and personality disorders and worsening with the deterioration of higher mental functions. Although Nietzsche's condition was compatible with a diagnosis of GPI, many of the symptoms observed are not specific to GPI and are compatible with a variety of neurological conditions. Due to this and other symptoms such as migraine and stroke episodes, new diagnoses have been proposed, such as retrobulbar meningioma, CADASIL, MELAS and FTD. The FTD hypothesis was suggested due to the onset of the clinical condition of early decline in social interpersonal conduct, in personal hygiene, emotional blunting, hyperorality, behavior compulsions, perseverative and stereotyped behavior and mood with inappropriate jocularity, symptoms noted on his admissions. Conclusion: Even after more than 100 years of Nietzsche's death, there are still questions about what caused it. When analyzing its history, contradictions, and uncertainties about the diagnosis of neurosyphilis are perceived, contributing to the emergence of other diagnostic hypotheses, such as Frontotemporal Dementia.

Palavras Chave

Friedrich Nietzche; Neurosyphilis; Frontotemporal Dementia

Área

História da neurologia