The Monakow Concept of Diaschisis

TLDR

The concept that focal brain damage can produce remote functional deficits, later formalized by Monakow as diaschisis, highlighted the importance of neural connectivity and recovery dynamics. This article reviews the origins of diaschisis and outlines Monakow’s objectives.

Abstract

The idea that damage to one part of the nervous system can have effects at a distance was popular during the 19th century. Constantin von Monakow, MD, accepted this idea and blended it with the newly formulated neuron doctrine early in the 20th century to account for ipsilateral paralyses and recovery of function. He called his theory of neural depression caused by loss of inputs to structures tied to the damaged area<i>diaschisis</i>. In this article, we examine the origins of diaschisis and the goals of Monakow. Credit is given to Monakow for drawing needed attention to the dynamics of the nervous system, remote lesion effects, and recovery of function, even though the fine details or specifics of his theory have had a mixed reception.