Jean Siegfried (1931-2014)

Jean Siegfried was one of the pioneers in stereotactic and functional neurosurgery. He was an outstanding representative of the second generation of neurosurgeons who were pupils of the founding giants in the field like Leksell, Riechert and Talairach, to mention a few. Siegfried lived and worked all his life in Zurich, and in the early 1960s he began to practice and further develop stereotactic neurosurgery at the University Hospital Zurich (Kantonsspital). For many years he was the leading neurosurgeon in that field in Switzerland. Siegfried soon gained an international reputation, and he took an active part in a number of international meetings. He was a member of the board of directors of several scientific societies and of the editorial board of medical journals. In 1981, he hosted a meeting of the World Society for Stereotactic and Functional Neurosurgery in Zurich. Siegfried's professional contributions were awarded with several prizes, among them the prestigious Otfrid Foerster Medal 2003.Jean Siegfried was born in Geneva where he went to school and where he also completed his medical studies in 1956. He practiced as a house surgeon in the French Hospital in London from 1957 to 1958, conducted scientific studies in Strasbourg in 1959, obtained clinical and research fellowships at the Montreal Neurological Institute (T. Rasmussen and H. Jasper) and at the Massachusetts General Hospital in 1962 (W. Sweet). In 1961, he presented a thesis in Geneva and became an assistant physician at the Neurosurgical Unit at the Kantonsspital in Zurich. In 1966, he became a specialist in neurosurgery, and in 1969 he was nominated as a ‘Privatdozent' after having presented a survey study on Parkinson's disease and its treatment. In 1975, he was conferred the title of Professor at the University of Zurich. Jean Siegfried was for many years one of the most prominent members of the neurosurgical staff at the Kantonsspital and had a solid international reputation. From 1986 till 2001 he moved his neurosurgical activities to the private hospital Klinik im Park in Zurich.Siegfried's scientific production reflects his wide interest in most techniques and indications for stereotactic and functional neurosurgical interventions. Most of his publications are from the period of 1970-1995. The first ones, from 1963, were produced in Boston, where he spent some time with the famous pain surgeon William Sweet, and dealt with stereotactic lesions produced by cold and applied in the treatment of choreo-athetosis. In the late 1960s, he published several papers together with Hugo Krayenbühl, the well-reputed head of the Neurosurgical Unit of the Kantonsspital in Zurich. Of particular interest are some publications on stereotactic cerebellar surgery (dentate nucleus) for hyperkinetic disorders. It should be borne in mind that such surgery did not come into general usage until much later, in the mid and late 1970s. This is an example of Siegfried's original and innovative mind in embarking upon new applications of available surgical techniques. He had a special interest in what was then often referred to as cerebral palsy, and in 1985 he surveyed this topic in an extensive article together with Yves Lazorthes and Giovanni Broggi.It should be noted that Siegfried was one of the pioneers in applying deep brain stimulation (DBS) both for chronic pain and for movement disorders. He had always had a keen interest in pain, and he wrote several articles on pain physiology and management, in particular surgical treatment options, which were generally published in local Swiss medical journals. In the 1970s and 1980s, he treated a large number of patients with trigeminal neuralgia, and already in 1977 a series of 500 cases was published. During the period from 1978 till 1985, Siegfried treated 89 patients with DBS applied to the sensory thalamus for deafferentation pain, and in 1984 he published a study together with Bertrand Demierre on thalamic pain treated by thalamic DBS. In 1995, Jean Siegfried and Yves Lazorthes reported on the long-term outcome of spinal cord stimulation in patients with neuropathic pain treated in Zurich and Toulouse. Although only a case study, it was a meticulously performed report of a large number of patients, and for several years it was in fact one of the best clinical studies on spinal cord stimulation - the fact that it was published in French made it presumably less often cited than it would deserve!Siegfried wrote several publications on the surgical treatment of Parkinson's disease. Of particular interest is a paper from 1991, which he published together with Serge Blond, demonstrating the possibility of alleviating both parkinsonian and essential tremor by thalamic DBS. It should be recalled that this was in the same year as the first paper on DBS from the Grenoble group was published. Another pioneering study by Siegfried is the one he published together with Bodo Lippitz in 1994, reporting for the first time on the effect of DBS applied to the pallidum in Parkinson's disease. In 1997, he published a book together with Serge Blond on the neurosurgical treatment of this disease and other movement disorders. During the last years of his professional life, when Siegfried worked at a private hospital, he was the first person in Switzerland to have access to a Gamma Knife. Judging from his publications from these years (1998-2001), he performed stereotactic radiosurgery predominantly on acromegaly and brain metastases.No doubt, Jean Siegfried's scientific production is impressive because it mirrors a broad interest and expertise in many aspects of his field - it also reveals an exceptionally innovative and creative surgical mind. Jean Siegfried had many interests beside his professional life. He was a knowledgeable collector of modern art and a music lover. He was also an active and accomplished skier.Siegfried was a warm, sociable and generous person who was always ready to share his ideas and experience with colleagues and friends. He had a charming humour and ready wit. Those of us who had the privilege of knowing Jean more closely than just professionally keep many memories of most enjoyable times spent with him.

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