Dementia Pugilistica – “Punch Drunk” – is CTE

By Attorney Gordon Johnson

Dementia Pugilistica, or “punch drunk” is a severe brain disorder caused by repeated blows to the head, regardless of whether the recipient of the blow is wearing a helmet. As described by H. Miller in 1966, when he coined the syndrome’s sister name, CTE, the disease includes movement disorders such as dysarthria, ataxia, tremors, and signs of cerebellar dysfunction. Pupillary changes, ophthalmoplegias and epilepsy are less constant, but more than half the patients are significantly demented. In 1973, a group led by J. A. Corsellis described the typical neuropathological findings of Dementia Pugilistica after post-mortem examinations of the brains of 15 former boxers.

Dementia Pugilistica began to be known by its pseudonym of CTE as a result of considerable research coming out of Boston and the Sports Legacy Institute in the last ten years. Much of that research included autopsy results of retired football players. Such research had a significant impact on the litigation against the NFL, which resulted in a substantial settlement on behalf of retired players in 2014.

Dementia Pugilistica effects all aspects of brain function. It involves the development of protein plaques called tau on brain tissue and neurofibrillary tangles, slowing and interfering with the function of brain tissue. It also involves progressive degeneration of the brain tissue. These changes in the brain can begin months, years, or even decades after the last brain trauma or end of active athletic involvement. The brain degeneration found in Dementia Pugilistica is associated with memory loss, confusion, impaired judgment, impulse control problems, aggression, depression, and, eventually, progressive dementia.

There is both an early phase of Dementia Pugilistica and a late phase. During the early stage, relatively young people will suffer primarily behavior and mood symptoms. In the later stages it involves a very early onset of severe cognitive and motor decline.