Neurological Disorder Inspired European Dancing Tradition

"As a child growing up in Luxembourg, I danced in the Dancing Procession of Echternach," said neurologist and study author Paul Krack, MD, of the University of Kiel in Germany. "It wasn't until later when I studied neurology that I learned of its significance to modern day movement disorders."

According to legend, the Dancing Procession of Echternach originated in the late eighth century after patients with tremor and paralysis were miraculously healed at the grave of the missionary Willibrord. News of the miracles spread and people began to dance at Willibrord's grave seeking protection from and cures for neurological disorders, and Willibrord soon became the patron saint of patients with neurological disorders.

During the 14th century plague epidemic in central Europe, Christians and pagans danced to seek protection from illness. These dances, based on religious fervor, pagan tradition or superstition, may have led to epidemics of mass hysteria. Neurologists later surmised that these epidemics were outbreaks of a disorder known as hysteric chorea, which caused involuntary dance-like movements.

These movements became known as the dancing disease or Saint Vitus' chorea. A chorea is an abnormal involuntary movement that occurs without purpose. The word stems from the Greek word chorea, which means dance. Saint Vitus' dance later became a term synonymous with Sydenham's chorea, a childhood condition associated with rheumatic fever.

Today the most common disease causing chorea is hereditary Huntington's disease. Neurologists most frequently see choreic-like movements as a side effect of levodopa treatment in Parkinson's patients.

Neurologists have sought to determine the significance of these dancing traditions. In the 1900s, neurologist Henri Meige studied the Dancing Procession of Echternach to look for chorea in the dancers. Throughout the procession he found no signs of chorea. He attributed the lack of chorea to two things. First, police took away people having epileptic or hysteric attacks during the dance. Second, patients could send a relative or hire a professional dancer to take their place.

Meige also examined epidemics of dancing disease of the medieval era. He believed that singing, dancing and laughing that occurred during these epidemics influenced brain functioning, and this may have led to the dancing disease of medieval times. He suggests that some people are more suggestible than others.

Krack agrees with Meige's conclusions of the medieval dancing disease. "Emotion, behavior and the movement systems are tightly linked in the brain," said Krack. "You'll see this in Parkinson's patients. On a smaller scale, think of the elation that a person feels while dancing, singing and laughing at a party."

Today, the Dancing Procession of Echternach occurs on the Tuesday following Pentecost. Dancers, in groups of four or five, take three steps forward, then two back; five steps are needed to advance one pace. The procession is a religious ceremony where people dance to folk music. "People join in the procession for fun or to pray for a disabled relative," said Krack.

"Though the people involved in the dancing procession today are not choreics and are not likely to be hysterics, the event shows the close interface between society and early medicine and between Christian and pagan traditions in Europe," said neurologist Christopher Goetz, MD, of Rush Medical College in Chicago, IL. "It represents an early glimpse at self-help therapies."

###

A neurologist is a medical doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system.

The American Academy of Neurology, an association of more than 16,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research.

For more information about the American Academy of Neurology, visit its Web site at http://www.aan.com. For online neurological health and wellness information, visit NeuroVista at http://www.aan.com/neurovista.