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A bstract The significance of the intracytoplasmic hyalin neuronal inclusions first described by Lewy over fifty years ago is discussed on the basis of an analysis of 50 autopsy cases in which Lewy bodies were an incidental finding. Lewy bodies were not found in any person younger than 62 in this series. The distribution of the inclusions was similar to that in 21 cases of idiopathic parkinsonism, and in half the cases there was similar although less severe, nerve‐cell loss in the substantia nigra. Twenty‐two per cent of the incidental cases eventually proved to have had some mild clinical symptomatology that might indicate parkinsonism. It is suggested that Lewy bodies are related to a specific abnormality of nerve‐cell metabolism, affecting the neuromelanin‐containing nerve cells in particular, and related to idiopathic parkinsonism rather than to age alone. Incidental cases may represent mild, early and preclinical cases of parkinsonism.
Lysia S. Forno (Sun,) studied this question.