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Have we found the ‘dynamic lesion’ of Jean-Martin Charcot in functional neurological disorders?
At the end of the 19th century, hysterical symptoms were regarded by one of the founders of modern neurology, Jean-Martin Charcot, as manifestations of a ‘dynamic lesion’ of the central nervous system. In 1889, he wrote: ‘There is, without doubt, a lesion of the nervous centres but where is it situated and what is its nature? … But certainly, it is not of the nature of a circumscribed organic lesion of a destructive nature … one of those lesions which escape our present means of anatomical investigation, and which for want of a better term, we can designate dynamic or functional lesion’.1
After 130 years of tremendous developments in neurosciences, we are now in possession of powerful ‘means of anatomical investigation’ and the question is: has neuroimaging revealed this lesion? Its location and nature?
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