Gabrielle Lévy
Gabrielle Charlotte Lévy, MD (1886 – 1934) was a French neurologist and neuropathologist.
Lévy wrote on the neurological consequences of war, and published numerous articles on post-encephalitic syndromes; and post-encephalitic movement disorders, such as parkinsonism, chorea, and myoclonus. These post-encephalitic syndromes formed the subject of her 314-page thesis, published in 1922 – Contribution à l’étude des manifestations tardives de l’encéphalite épidémique
Lévy worked and published with significant French neurologists including Marie, Roussy, Lhermitte and Béclère. Roussy, in his eulogy, noted that Lévy was predominantly second author on papers that she performed the bulk of the work on. Collaborations he provided as examples including: work on involuntary movements, rhythmic movements and extra-pyramidal or cerebellar disorders with Pierre Marie; a Monograph on the radiology of the nervous system with Antoine Béclère; and phenomena of peduncular hallucinosis with Jean Lhermitte
With Roussy, she described a syndrome characterized by a hereditary polyneuropathy, ataxia, tremor, and foot deformities, the Roussy-Lévy syndrome (1926). Lévy also published papers on radiotherapy for brain tumours, and on diabetes insipidus following head injury.
Biography
- Born 11 January 1886 in Paris, France
- 1911-1915 – Medical studies, externat, in Paris at the Hôpital de la Pitié, (with Professor Enrique) Hôpital des Enfants-Malades (with Professor Marfan) and Hôpital Beaujon (with Professor Oulmont)
- 1915-1918 – Externe en premier to Pierre Marie (1853-1940) at the Salpêtrière Hospital
- 1918-1919 – Completed internship under Pierre at the Salpêtrière Hospital age 33. In 1918 Lévy’s first article was a collaboration with Pierre Marie describing 10 cases of movement disorders associated with encephalitis lethargica.
- 1920-1922 – Chief of the Salpêtrière laboratory.
- 1922 – MD Thesis, Paris: Contribution à l’étude des manifestations tardives de l’encéphalite épidémique.
- Lévy subsequently published another 13 articles on the subject of post encephalitic syndromes, culminating in her 314 page thesis which provides an extensive description of post encephalitic syndromes in three parts:
- (a) clinical section, describing the excito-motor syndrome, parkinsonian syndrome, other neurological manifestations, and other general disorders, including respiratory and sleep problems, lasting mental changes, paediatric manifestations, and prognostic aspects;
- (b) pathologic-anatomical section with details of four cases; and
- (c) descriptions of 68 of the 129 cases she had studied for her thesis from the Salpêtrière Hospital. The majority of the cases were aged between 10 and 50 years.
- 1923-1926 – Assistant at the pathology department at Salpêtrière
- 1925 – Associate physician (aged 39) at the Paul-Brousse Hospital with Gustave Roussy (1874 – 1948). Her thesis was later published as a book, Les manifestation stardives de l’enchéphalite épidémique in 1925.
- 1927 – Published with Lhemitte expounding on his sign description from 1924. The papers begs the question ‘A new symptom of multiple sclerosis! Is it necessary to enrich it with more symptomatology?’ and concludes that Lhemitte sign may be a useful early symptom in MS, when objective signs are still lacking.
- 1934 – Attending physician, Paul-Brousse Hospital
- Died on October 6, 1934 aged 48 following ‘a progressive and malignant disease of the nervous system’.
Original
English
Sa vie fut un exemple de labeur, de courage, d’énergie, de ténacité, tendus vers ce seul but, cette seule raison: le travail et le devoir à accomplir.
Et je dois à la vérité de dire aussi, puisque son nom fut souvent placé aux cotes du mien, que, dans la collaboration, c’est à elle que revenait presque toujours l’idée première d’un travail à entreprendre au très grand part dans son exécution.
Her life was an example of labor, of courage, of energy, of perseverance, directed at that single target, that single reason: the work and the duty to fulfil.
And I have to say that in our collaboration, in which my name was often mentioned with hers, it was almost always her first idea and the largest part was done by her.
Medical Eponyms
Roussy-Lévy syndrome (1926)
Lévy and Gustave Roussy (1874 – 1948) described dystasie aréflexique héréditaire (hereditary areflexive dystasia). It is a disease of the peripheral nervous system. Dominantly inherited condition associated with partial duplication at chromosome 17p11.2. related to the spinocerebellar degenerations and manifesting pes cavus, sensory and gait ataxia, areflexia, awkward movements, and a mild cerebellar intention tremor, but no nystagmus, present from the time of infancy. Syndrome now thought to be hereditary motor and sensory neuropathy (HMSN) with benign essential tremor.
Following the description of the seven patients, the authors summarized the main signs, notably (1) gait and standing problems; (2) areflexia; and (3) clubfoot
In some family members additional findings included slight clumsiness of the hands, rarely a tendency to atrophy of the palm muscles, and disappearance of the cutaneous reflexes.
Original
English
Nous avons eu l’occasion d’observer sept cas d’une maladie familiale dont la symptomatologie nous a paru singulière, et non encore décrite
We have had the occasion to observe seven cases of a familial disease, of which the symptomatology appeared remarkable, and not yet described
They concluded by stating that even if, in future, the disease would appear to be from an aberrant form of a previously classified familial disease, their observation would still be a valuable area of research with respect to the evolution and varieties of familial diseases.
Levy and Roussy published follow up work to their first paper in 1934 they discussed the comparisson between Friedreich’s disease and Charcot-Marie’s amyotrophy.
“It is irrefutable that ‘hereditary areflexic dystasia’ presents with characteristics that links it, at one side to Friedreich’s disease, on the other side to the amyotrophy of Charcot-Marie.”
Roussy, Levy 1934
The disease is now known to be caused by either a heterozygous mutation in the peripheral myelin protein (PMP)-22 gene or the myelin protein zero gene (MPZ).
Lhermitte-Lévy syndrome (1931)
Slowly progressing paralysis following a stroke, with incessant choreiform movements of arms and legs (rhythmic trembling), and visual and auditory hallucinations.
Major Publications
- Lévy G. Contribution à l’étude des manifestations tardives de l’encéphalite épidémique [Contribution to the study of the late manifestations of epidemic encephalitis]. Thèse 1922
- Lévy G. Le syndrome excito-moteur tardif de l’encéphalite épidémique. Le Journal Médical français 1923; 12(4).
- Marie P, Lévy G. La forme respiratoire de l’encéphalite épidémique. Le Monde Médical de Médecine et de Thérapeutique 1923; (634)
- Roussy G, Laborde S, Lévy G. Traitement des tumeurs cérébrales par la radiothérapie. (A propos de cinq cas de gliomes cérébraux). Revue neurologique 1924; 31(2): 129-45.
- Lévy G. Le traitement des lésions, en particulier des tumeurs, de la région infundibulo-hypophysaire. Annales de Médecine 1925; 18(6): 479-505
- Lévy G. Les manifestations tardives de l’encéphalite épidémique. 1925
- Roussy G, Lévy G. Sept cas d’une maladie familiale particulière: Troubles de la marche, pieds bots et aréflexie tendineuse généralisée, avec, accessoirement, légère maladresse des mains. Revue neurologique, 1926; 1: 427-450 [Roussy-Lévy syndrome]
- Lhermitte J, Lévy G, Nicolas M. Les sensations de décharge électrique symptôme précoce de la sclérose en plaques. Clinique et pathogénie. La Presse Médicale. 1927; 39: 610-613. [Lhermitte sign]
- Béclère A, Lévy G. Radiothérapie dans les maladies du système nerveux. In: Lazarus P (ed.): Handbuch der gesamten Strahlenheilkunde, biologie, pathologie und therapie. München, Bergmann, 1928.
- Lhermitte JJ, Lévy G. L’hallucinose pedonculaire. Revue neurologique, 1931; I: 312–318.
- Lhermitte JJ, Lévy G. Phénomènes d’allucinose chez une malade presentant une torsion et une contracture athetoides intentionnelles du bras. Revue neurologique, 1931; I: 609-610 [Lhermitte-Lévy syndrome]
- Lévy G. Les formes conscientes de l’automatisme verbal et leurs analogies avec certaines manifestations de l’automatisme comitial (palilalie, écholalie, échopalilalie aphone). La Presse Médicale 1931; 73: 1344-1347
- Roussy G, Lévy GA. La dystasie aréflexique héréditaire. La Presse Médicale. 1932; 93: 1733-1736 [Roussy-Lévy syndrome]
- Roussy G, Lévy GA. A propos de la dystasie aréflexique héréditaire. Revue neurologique 1934; 62: 763-773 [Roussy-Lévy syndrome]
References
- Roussy G. Gabrielle Lévy. La Presse médicale. 1934; 84: 1653-1654
- Gabrielle Lévy, MD. Journal of Nervous and Mental Disease 1935; 81(6): 725-726
- Beighton P, Beighton G. LEVY, Gabrielle. In: The Man Behind the Syndrome. Springer 1991 XXX
- Koehler PJ. Gabrielle Lévy and the Roussy-Lévy syndrome. J Hist Neurosci. 2018;27(2):117-144.
- Thomas E, Aziz-Donnelly A, Garcia-Santibanez R. Women in the History of Neuromuscular Medicine. Neuromuscular Disorders. 2019; 29: 698-703
- Bibliography. Lévy, Gabrielle. WorldCat Identities
Graduated from Southampton Medical School in 2017 with BMBS. Working in Sir Charles Gairdner Hospital Emergency Department in Perth, Australia.
