Musical Shrapnel, Creeping Paralysis, and the Neurology of Shostakovich

Abstract

Dmitri Dmitriyevich Shostakovich (DDS) (1906-1975), was one of the most original, influential, and meaningful composers of the twentieth century. Many of his compositions reflect the social and political events of Stalin-led Russia, and the conflict between the government and the individual freedom of artistic expression. The philosophy and purpose in much of his music can be viewed as a connection with, a reflection of, and an inspiration to the people of Russia, and as defiance towards oppressive leadership. Shostakovich’s life was shaded by a series of chronic health challenges. A Russian neurosurgeon is attributed with stating that he saw DDS for a shrapnel injury to the head (from World War II) resulting in a mobile metal fragment in the left lateral ventricle. Tilting the head in a stereotyped fashion resulted in creating novel musical ideas. The more disabling and widely documented condition that limited DDS’ physical function for 15-20 years was a gradual progressive paralytic disorder causing asymmetric limb weakness. In this chapter, we review the available historical data and explore the localization and diagnosis of this disabling condition. In the context of a contemporary neuromuscular evaluation, the possibilities of motor neuron disease, Hirayama disease, spondylosis myeloradiculopathy, syringomyelia, thoracic outlet syndrome, multifocal motor neuropathy, and lead poisoning are explored. His remarkable cultural contributions, in the setting of such adversity, serve as inspiration for all those beset with chronic neurological illness.