European Sleeping Sickness – Causes, Symptoms & Treatment

European sleeping sickness

European sleeping sickness is the name of an inflammation in the brain that can be accompanied by sudden, severe disturbances of consciousness and neurological deficits. Those affected fall uncontrollably into a deep sleep and are often unresponsive afterwards. Many are in complete physical and mental torpor. Headache, nausea and fever often follow. The disease occurred frequently in Europe between 1915 and 1927 and even resulted in deaths during this period. Later, only very rare outbreaks were recorded.

What is European sleeping sickness?

The disease was discovered and first described in 1916 by the Austrian psychiatrist and neurologist Constantin Freiherr Economo von San Serff (1876-1931). It was also named economo disease after him . The term encephalitis lethargica is better known . Sufferers were often caught sleeping in the most uncomfortable postures, such as while eating or in the middle of work.

Some were easily awakened, but others died quickly. Economo found frequent paralysis of the eye muscles and found case reports from previous centuries that were located on the European continent.

The famous British neurologist Oliver Sacks (1933-2015) left behind impressive descriptions of the fates of patients suffering from European sleeping sickness. In the late 1960s, as a young doctor in the neurology department of a hospital in the USA, he met some victims of European sleeping sickness, specifically the epidemic of the 1920s.

With a special nerve agent, he was able to regain consciousness in several patients within a short time. Some of them had thus awakened from their torpor after years of mental standstill. Because they could not cope with this completely new personal situation, they fell back into general rigidity or developed other mental illnesses.


Most encephalitis is caused by viruses. Rarely, bacteria or other pathogens are the triggers of encephalitis . Children, young adults and patients with an impaired immune system are particularly at risk. The viruses ( e.g. herpes simplex virus , varicella zoster virus , Epstein-Barr virus ) either cause inflammation directly in the brain or block the body’s own defense system. Eligible pathogens are also protozoa, parasites and fungi.

Symptoms, Ailments & Signs

Sudden high fever , nausea , unusually severe headaches and initially slight clouding of consciousness can indicate encephalitis . Concentration and memory are suddenly deficient .

Significant changes in behavior occur, including mood swings and disorientation . Speech and speech can be slightly disturbed. If left untreated, the disease very often leads to death. If it is recognized early and treated correctly, there are very good prospects of recovery.

Permanent damage to the nervous system occurs only rarely. However, it may not appear until many years later. In the clinic, the neurological department is therefore always responsible for encephalitis. When treated with medication, around 80 percent of patients recover. Persistent seizures and swelling of the brain pose a life-threatening risk .

Diagnosis & History

The doctor’s diagnosis of suspected European sleeping sickness is extremely varied. He needs information about general symptoms, the previous medical history and possible viral infections. He will also listen to descriptions from relatives or companions because the encephalitis patient often has conspicuous problems with the ability to perceive and communicate.

Information about recent trips and possible contact with persons at risk, such as people suffering from encephalitis, is also important. With physical and neurological examinations, the doctor then tests the patient’s chest and head area, his reflexes and reactions to stimuli.

He can recognize and interpret irregularities in the skin as well as impairments in the water balance. If encephalitis or specifically encephalitis lethargica is suspected, the doctor will thoroughly examine the blood and brain fluids to find out the type and danger of the pathogen and any signs of inflammation.

Reliable knowledge about this can often only be gained after a few weeks. In order to exclude possible other brain diseases, the doctor can also resort to the evaluation of computed tomography , magnetic resonance imaging and electroencephalography.


European sleeping sickness is caused by encephalitis. This is now relatively rare, but can lead to complications due to the severity of the disease. Encephalitis lethargica or encephalitis Vienna can lead to Parkinson’s-like symptoms or conditions that resemble a coma .

A further complication of this disease can be viewed as neurological disorders that appear years later. The American neurologist Oliver Sacks was able to temporarily eliminate such symptoms with the administration of L-Dopa. This led to tragic complications for some of the resuscitated patients. They could not bear the new state of wakefulness after years of dozing.

As a result, they became depressed or mentally ill. The prognosis for such complications of European sleeping sickness is usually poor. The problem is that European sleeping sickness cannot be traced back to a specific pathogen. Due to initially non-specific symptoms, the risks of later complications are relatively high.

For example, a persistent seizure (status epilepticus) may occur. In other cases, cerebral edema develops due to swelling in the brain. Both complications of European sleeping sickness can have life-threatening consequences for those affected. Since the causative agent of European sleeping sickness has not yet been identified, complications can hardly be ruled out. Parkinson’s syndrome can occur as a result of European sleeping sickness .

When should you go to the doctor?

If a sudden high fever, unusually intense headache, and other signs of encephalitis occur, an ambulance should be called. Mood swings and changes in behavior are other warning signs that are best addressed right away. In case of unconsciousness, the emergency services must be alerted immediately.

Until professional help arrives, it is advisable to check your pulse and heartbeat regularly. In addition, the affected person must be placed in the stable side position so that he does not suffocate. Afterwards he usually has to spend some time in the hospital.

Whether further visits to the doctor are necessary depends very much on how the European sleeping sickness progresses. In the event of pain, seizures and other complaints, you should always speak to the responsible doctor. Children, the elderly and patients with a compromised immune system are particularly likely to develop encephalitis. A targeted examination for encephalitis is recommended for these risk groups after a viral infection. The earlier the disease is detected, the better the chances of recovery are normally.

Treatment & Therapy

The treatment of encephalitis is always carried out in an inpatient clinic, because potentially life-threatening escalations in the course of the disease can be recognized and compensated for here immediately. The administration of medication is also completely traceable and can be modified depending on the type of pathogen and the severity of the disease.

In the early stages of encephalitis, certain drugs may be ineffective until the cause of the disease is definitively established. They are then immediately replaced in the hospital with more suitable drugs. The use of medication to reduce fever, against brain changes, pain and possible seizures is also precisely tailored to the needs of the patient in the clinic.

Outlook & Forecast

With the European sleeping sickness, which only occurs occasionally today, irreversible damage occurs in the neuron network of the brain, which makes it impossible to cure the disease. Although the sleep attacks are temporary at first, the disease progresses and damages the neural network more and more.

In the acute state, the affected patients suddenly fall asleep and often maintain uncomfortable postures. Sleep is so deep that it often resembles a coma-like state. At the time of the greatest spread of the disease in the years between 1915 and 1927, it was found that about a third of those affected died. Death often occurs very quickly, although the sick can always be awakened.

Surviving patients later suffer from paralysis of the eye muscles and paralysis of the eyelids, among other things. Many years after the sleep attacks, neurological problems appear, which in turn lead to the same symptoms as in the initial stages and then result in the patient becoming completely insane. Those affected seem self-forgotten and fall into complete rigidity.

The neurologist Oliver Sacks achieved success with an experimental L-Dopa therapy. L-Dopa has a stimulating effect and can bring patients out of a state of torpor. However, this awakening from complete mental torpor is often only short-lived. Some patients fall back into mental paralysis because they cannot cope with the new situation after waking up.


To prevent the brain disease encephalitis, vaccinations are recommended, which can help against a wide variety of pathogens. Since they fight similar strains of pathogens, vaccinations against measles , mumps , rubella and polio are also appropriate for increased resistance to Economo disease. There are also a wide variety of special vaccinations for people with an increased risk of neurological disease.

In this regard, particular attention should be paid to the administration of serum against tick -borne encephalitis (FSME) , which is transmitted by ticks. A TBE is a brain inflammation whose viral pathogens are very active. There are also some risk areas for this disease, which mainly occurs in spring and summer, in Germany. Travelers to Southeast Asia are also advised to take preventive vaccinations against what is known as Japanese encephalitis, which is widespread there.


In most cases, those affected by this disease have no follow-up care available. The disease itself must first and foremost be examined and treated directly by a doctor so that there are no further complications that can further complicate the everyday life of the person affected. The person affected should consult a doctor at the first sign of this disease so that it can be treated quickly.

If the disease is left untreated, it can lead to serious complications that significantly reduce the quality of life of those affected. In most cases, patients with this disease are dependent on treatment by a psychologist. The treatment should be carried out regularly in order to properly alleviate the symptoms.

The affected person should definitely avoid stress in his life, as this definitely promotes the disease. Various techniques for relaxation can limit the disease and also make life easier for the patient. Contact with other patients with the same disease can also be useful, as this leads to an exchange of information. As a rule, life expectancy is not reduced by this disease.

You can do that yourself

Since encephalitis can always be life-threatening, one of the most important self-help measures is to interpret the symptoms correctly and to consult a doctor as soon as possible. In addition to fever and nausea, the first signs are very severe headaches and changes in behavior, which manifest themselves in particular in the form of mood swings and disorientation. Such symptoms must not be downplayed as side effects of the onset of flu, but must be discussed with a doctor immediately.

Children and young people, as well as patients with a weak immune system , are particularly at risk . The immune system can be positively influenced by lifestyle. A healthy diet rich in vitamins and fiber , mostly based on plants, as well as regular exercise in the fresh air strengthen the body’s own defences. On the other hand, it is important to avoid unhealthy foods, especially fatty meat, sausage, sugar and white flour products, as well as excessive consumption of alcohol and cigarettes.

People with an increased risk of neurological disease should really take advantage of the special vaccinations that are available for them. In addition, vaccinations against certain childhood diseases such as measles, mumps and rubella can reduce the risk of contracting European sleeping sickness.

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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.