Case Records of the Historical Grand Rounds:
Case 7: Felix Mendelssohn 

Felix Mendelssohn-Bartholdy, 1809-1847

Felix Mendelssohn was one of the great yet under appreciated composers of the German-romantic movement. Born into a wealthy Jewish family, he was the grandson of the famous rabbinic philosopher Moses Mendelssohn, though abandoned Judaism to live as an assimilated protestant. He was known as one of the great virtuoso pianists of his age and his compositions are now appreciated for their melancholic, restrained romanticism that never quite abandons the classical age.

Despite being a product of the romantic era, Mendelssohn was staunchly conservative in his musical tastes. His enthusiasm for baroque music, J.S. Bach in particular, revived the public’s interest in these works an elevated Bach from a largely forgotten church organist to a composer of historical importance. He clashed with many of his colleagues, but his sensibilities found a welcome home in England, where he premiered most of his works. The British Royal family even used a piece from his opera A Midsummer Night’s Dream for Princess Victoria’s wedding in 1858. The tradition endures to this day. 

The Mendelssohn family had a history of premature deaths that was unfortunately passed on to Felix. His grandfather, father, and two sisters all died of what appeared to be a series of strokes separated by years with seizure-like symptoms in between. Felix's first stroke occurred at the age of 30 and presented as tingling and temporary loss of function in his hands. A similar event took place seven years later, around the time his sister Fanny died from “apoplexy”. This rendered him speechless for some time. In the following days he had two more strokes that made him immobile and caused him severe headaches described as “a foreign body wanting to impress itself forcefully into his head”. He became delirious and died after a few fruitless attempts by his doctors to revive him with leeches and vinegar massages. Considering his strong family history, it is possible he suffered from an autosomal dominant syndrome that often presents with multiple strokes before age 50. What is it?

Spring Song:

Wedding March: https://www.youtube.com/watch?v=z0wmzoHd6yo

Answer: CADASIL syndrome (Cerebral Autosomal-Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy)