A case of chorea, epilepsy and cerebral atrophy in the work of Ettore Ravenna (1920s)

This study re-examines a rare neuropathological case documented by Ettore Ravenna in 1900, involving a young patient with chorea, epilepsy, and marked frontal lobe atrophy. Using Ravenna’s original autopsy notes and the preserved anatomical preparation at the Morgagni Museum of Human Anatomy (Padua), the case is reassessed in light of modern neurological knowledge. Macroscopic examination confirmed severe anterior frontal atrophy with relative preservation of peri-Sylvian regions, consistent with the patient’s ability to sing despite profound language impairment. Ravenna described gliosis, fibrotic tissue replacement, and neuronal hyaline degeneration, interpreted as ulegyria of inflammatory origin. Although he considered epilepsy and chorea expressions of a single pathology, current research differentiates their mechanisms. However, juvenile neurodegenerative disorders such as Huntington disease show overlapping seizures, chorea, and cortical atrophy, partially supporting his observations. Re-evaluating this case highlights its historical relevance and the value of anatomical collections in reassessing early diagnoses.