ЭКСТРАПИРАМИДНЫЕ РАССТРОйСТВА ПОЗЫ И ТОНУСА: ИСТОРИчЕСКИй АСПЕКТ ВОПРОСА ДО СЕРЕДИНЫ XX ВЕКА Медицинский центр по делам ветеранов системы здравоохранения Великих озер, неврологическое отделение, Тома, Висконсин, США Lanska D.J. EXTRAPYRAMIDAL DISORDERS OF POSTURE AND TONE: HISTORICAL DEVELOPMENTS TO THE MIDDLE OF THE 20TH CENTURY neurology service, veterans affairs medical center, great lakes healthcare system, tomah, Wisconsin, usa В историческом аспекте изучение расстройств поддержания позы и тонуса – это прежде всего развитие учения и понимание таких нозологий, как болезнь Паркинсона, некоторых «Паркинсонизм-плюс»-синдромов, наследственных торсионных дистоний и различных фокальных и сегментарных дистоний. <...> Заключение: несмотря на развитие фармакологии и значительное облегчение состояния многих пациентов, доступная в настоящее время лекарственная терапия несет лишь временный эффект, нередко приводя к развитию серьезных побочных эффектов. <...> DOI: http://dx.doi.org/10.18821/1560-9545-2015-20-6-50-61 Historical developments in our understanding of extrapyramidal disorders of posture and tone to the middle of the 20th century emphasized Parkinson’s disease, some “Parkinson-plus syndromes, hereditary torsion dystonias, and various focal or segmental dystonias. results: The classic clinical description of Parkinson’s disease was given in 1817 by James Parkinson in his monograph entitled an Essay on the Shaking Palsy. <...> Beginning around 1860, Jean-Martin Charcot and his students worked to clarify and refine the cardinal features of the disorder, began to elaborate the clinical spectrum of this disease, and developed heuristics to distinguish Parkinson’s disease from other disorders. <...> In particular, Charcot elaborated rigidity and bradykinesia as cardinal features of Parkinson’s disease, and recognized that weakness per se is not a feature of this disorder. as early as 1888, Charcot recognized and began to characterize the clinical features of atypical parkinsonism, which anticipated later descriptions of multisystem atrophy, Wilson’s disease, and encephalitis lethargica in the early 20th century. <...> Elaboration of the pathology and pathophysiology of Parkinson’s disease and Wilson’s disease ultimately led to the development of rational therapeutics with levodopa and dopamine agonists for Parkinson’s disease, and with chelators (BaL, penicillamine, triethylene tetramine), zinc, and liver transplantation <...>