Skip to main content Accessibility help
×
Home
Hostname: page-component-559fc8cf4f-67gxp Total loading time: 0.419 Render date: 2021-03-05T04:03:34.493Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": false, "newCiteModal": false, "newCitedByModal": true }

Ladislav Haskovec and akathisia: 100th anniversary

Published online by Cambridge University Press:  02 January 2018

Pavel Mohr
Affiliation:
Prague Psychiatric Center, Charles University of Prague, Ustavni 91, 181 03 Praha 8, Czech Republic
Jan Volavka
Affiliation:
Nathan Kline Institute, Orangeburg, New York University, New York, USA
Rights & Permissions[Opens in a new window]

Abstract

Image of the first page of this article
Type
Columns
Copyright
Copyright © Royal College of Psychiatrists, 2002 

Akathisia is a syndrome of objective and subjective motor restlessness manifested by an inability to sit or stand still. The patients are distressed and they pace constantly. Today, it is mostly known as a side-effect of antipsychotic medications. However, the phenomenon was observed before the introduction of antipsychotics, and the term ‘akathisia’ (derived from the Greek ‘inability to sit’) was coined in 1901 by Ladislav Haskovec, MD. A Czech neuropsychiatrist, Haskovec was born in 1866 and died in 1944.

After graduation from the Charles University School of Medicine in Prague, he spent a year in Paris working with Professor Charcot, the leading neurologist at that time. His original primary interest was neuropathology, but he soon branched out into many other areas. He published on thyroid function, tuberculosis, alcoholism, neuroses, obsessions, mechanisms of consciousness, seizure disorders and heredity. His publications and presentations earned him international recognition and numerous honours in Austria, Czechoslovakia and France. He was appointed full professor at the Charles University in 1919, and served as Dean of the Charles University School of Medicine in 1925-1926.

Throughout his long career, Haskovec was an astute clinician. He coined the term ‘akathisia’ to describe symptoms he observed in two of his patients. These two case reports were presented at the meeting of the Société de Neurologie in Paris on 7 November 1901 (Reference HaskovecHaskovec, 1901). (English translations of Haskovec's papers with a commentary were published elsewhere (Reference BerriosBerrios, 1995).) The patients were adult males who had a multitude of symptoms including insomnia, vertigo, various aches and pains, and paraesthesias. Both men complained of generalised tremor; apparently this was not observed during examination. The prominent symptom in both patients was that they were unable to remain sitting down for any length of time. When sitting, at least one of the patients had a sensation in his legs as if he were jumping (today, a clinician would perhaps describe this sensation as a feeling of restlessness). The movements were described as involuntary by the patients who actually wanted to stop them; one of them tried to hang on to a table to prevent himself from getting up. After jumping up from the sitting position, the patient kept walking around, and conversation with him was only possible when he was moving. Gait was normal in both patients; neurological examination revealed no clear abnormalities, and there were no signs of psychosis.

Haskovec tentatively diagnosed one man with ‘hysteria’ and the other one with ‘neurasthenia’. He speculated about underlying mechanisms along the lines of ‘hyper-excitability’ or ‘fatigue’ of various brain structures, using theoretical concepts of his era.

The report elicited discussions with French neurologists who accepted the new term but wanted to apply it differently from its originator (Reference HaskovecHaskovec, 1903). Nevertheless, today's phenomenology of akathisia remains essentially the same as described by Haskovec 100 years ago. Neurology textbooks of the pre-antipsychotic era described akathisia in Parkinsonian patients, and the importance of the term has further increased after the introduction of antipsychotics in the 1950s. Neurologists and psychiatrists are indebted to Haskovec for his astute observations.

References

Berrios, G. E. (1995) Lad Haskovec and akathisia: an introduction. History of Psychiatry, 6, 243251.CrossRefGoogle Scholar
Haskovec, L. (1901) L'akathisie. Revue Neurologique, 9, 11071109.Google Scholar
Haskovec, L. (1903) Nouvelles remarques sur l'akathisie. Nouvelle Iconographie de la Salpêtrière, 16, 287296.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.

Altmetric attention score

Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 67
Total number of PDF views: 90 *
View data table for this chart

* Views captured on Cambridge Core between 02nd January 2018 - 5th March 2021. This data will be updated every 24 hours.

Access

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Ladislav Haskovec and akathisia: 100th anniversary
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Ladislav Haskovec and akathisia: 100th anniversary
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Ladislav Haskovec and akathisia: 100th anniversary
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *