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96-406: Gormenghast may refer to: Gormenghast (series) , a trilogy of novels by Mervyn Peake Gormenghast (novel) , second in the series Gormenghast (opera) , an opera based on the books Gormenghast (TV serial) , a BBC adaptation Topics referred to by the same term [REDACTED] This disambiguation page lists articles associated with

192-546: A family history , from which 5–10 percent can be attributed to a causative risk gene mutation , although harboring one of these mutations may not lead to the disease. As of 2024, around 90 genetic risk variants across 78 genomic loci have been identified with studies employing next-generation sequencing (NGS) to uncover detailed insights into these genetic factors. Notable risk genes include SNCA , LRRK2 , and VPS35 for autosomal dominant inheritance, and PRKN , PINK1 , and DJ1 for autosomal recessive inheritance. LRRK2

288-434: A monkey from somewhere. Otherwise, the impression given is that Gormenghast is stagnant, insular and introspective. A recurring theme is the time-consuming, complex and pointless rituals that the inhabitants submit to regularly, the origin and purpose of which is long forgotten. Gormenghast makes a stark contrast with the industrious and technologically advanced city that is the setting of Titus Alone . The story begins with

384-399: A bony face as this could give normal utterance, but rather that instead of sounds, something more brittle, more ancient, something drier would emerge, something more in the nature of a splinter or a fragment of stone. Nevertheless, the harsh lips parted. "It's me," he said, and took a step forward, his joints cracking as he did so. His passage across a room -- in fact his passage through life --

480-505: A clear sensorium . It might overlap with other psychiatric symptoms, making the diagnosis challenging. Impulse-control disorders (ICD) can be seen in approximately 19 percent of all patients and, in the context of PD, are grouped along with compulsive behavior and dopamine dysregulation syndrome (DDS) within the broader spectrum of impulsive and compulsive behaviors (ICB). They are characterized by impulsivity and difficulty to control impulsive urges and are positively correlated with

576-477: A crag, after giving birth to a daughter — The Thing. Dark, almost lambent like a topaz, she is still young, her sole disfigurement the universal bane of the Outer Dwellers, the premature erosion of an exceptional beauty — a deterioration that follows with merciless speed upon an adolescence almost spectral. The Thing: The daughter of Keda, foster sister of Titus. Due to her illegitimacy, she

672-439: A dark figure stole forth, closing the door behind him quietly, and with an air of the deepest dejection.... His face was very long and was olive coloured. The eyes were large, and of an eloquence, withdrawn. His nostrils were mobile and sensitive. His mouth, a narrow line.... The Countess Gertrude: 76th Countess and Titus's mother. An immense, statuesque woman with coils of dark red hair, she pays little attention to her family or

768-405: A deep bond with him. Of all Titus's family, she is the one he loves most. Fuchsia also experiences a brief bond with her father, Lord Sepulchrave, during his mental breakdown after the library fire. Broken by years of loss, disappointment, and disillusionment, she is killed as she accidentally slips from the windowsill where she was standing contemplating suicide. As she falls, she strikes her head on

864-738: A direct role in neurodegeneration , while Lewy bodies are thought to serve as an indirect marker of disease progression. A vicious cycle linked to neurodegeneration involves oxidative stress , mitochondria, and neuroimmune function, particularly inflammation . Normal metabolism of dopamine tends to fail, leading to elevated levels of reactive oxygen species (ROS) which is cytotoxic and causes cellular damage to lipids , proteins , DNA , and especially mitochondria. Mitochondrial damage triggers neuroinflammatory responses via damage-associated molecular patterns (DAMPs), resulting in aggregation of neuromelanin , and therefore, fueling further neuroinflammation by activating microglia . Ferroptosis

960-545: A few contributing factors have been identified. Pathophysiology is characterized by progressively expanding nerve cell death originating in substantia nigra , a midbrain region that supplies dopamine to the basal ganglia , a system involved in voluntary motor control . The cause of this cell death is poorly understood but involves alpha-synuclein aggregation into Lewy bodies within the neurons . Other possible factors involve genetic and environmental mechanisms, medications, lifestyle, and previous conditions. Diagnosis

1056-413: A futuristic city dominated by scientists and advanced technology . He then travels to a region where a huge modern factory stands by a lake, filled with identical-looking workers. There is a smell of death from the factory and it is hinted that sinister experiments are taking place there. Titus is increasingly haunted by his memories of Gormenghast and begins to realise its importance to his identity. At

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1152-454: A large cast of characters. These include: Titus Groan: The main character of the series, and heir to the Earldom of Gormenghast. He succeeds to the title of 77th Earl while still a child, but as he grows older, he develops ambivalent feelings toward his home. He is torn between pride in his lineage and the desire to escape from the castle and its traditions. Titus is born at the beginning of

1248-485: A major DNA damage -repair signaling kinase , and non-homologous end joining DNA repair pathway. Identifying environmental risk factors and causality is difficult due to the disease's often decade-long prodromal period. Most noteworthy environmental factors include pesticide exposure and contact with heavy metals. In particular, exposure to pesticides such as paraquat , rotenone , benomyl , and mancozeb causes one in five cases, implying an association with

1344-574: A race apart from the Castle dwellers, living by their own cultural norms and customs, which are impenetrable to outsiders. Keda: A woman from the Bright Carvers' village just outside the walls of Gormenghast. She is chosen to be Titus's wet nurse, but eventually leaves this position. She has two lovers, Braigon and Rantel, who fight a duel and both die for her, but not before one of them impregnates her. Eventually, she kills herself by leaping off

1440-453: A series of books following Titus Groan through his life, as well as detailing his relationship with Gormenghast. At least two other books, tentatively titled Titus Awakes and Gormenghast Revisited , were planned but Parkinson's disease and Peake's ensuing death at the age of 57 prevented him from writing more than a few hundred words and ideas for further volumes. Only three pages of Titus Awakes were coherently written and can be found in

1536-487: Is a fantasy series by British author Mervyn Peake , about the inhabitants of Castle Gormenghast, a sprawling, decaying, Gothic structure. Originally conceived as a single on-going novel, the series was ended by Peake's death and comprises three novels: Titus Groan (1946), Gormenghast (1950) and Titus Alone (1959); and a novella, Boy in Darkness (1956). Peake was writing a fourth novel, Titus Awakes , at

1632-537: Is a certain element of dignity and nobility. At heart he is kindly, and if weak, at least has the humility to be aware of his faults. He begins a rather unusual romance with Irma Prunesquallor. He becomes something of a father figure to Titus. He was a fine-looking man in his way. Big of head, his brow and the bridge of his nose descended in a single line of undeniable nobility. His jaw was as long as his brow and nose together and lay exactly parallel in profile to those features. With his leonine shock of snow-white hair there

1728-528: Is a hodge-podge of mud dwellings inhabited by the "Bright Carvers", villagers whose only contact with the aristocrats is their annual ritual of carving elaborate objects out of wood and presenting them to the Earl for his judging of the winning carving. They are in awe of the "Castles", as they call Gormenghast's elite inhabitants. Some contact with the outside world is implied; Dr Prunesquallor at one point sketches an ostrich skeleton, while Steerpike procures

1824-493: Is a stunted, cantankerous pedant of seventy, who stepped into his father's shoes (or, to be exact, his shoe, for this Barquentine is a one-legged thing who smites his way through ill-lit corridors on grim and echoing crutch). Bellgrove: School Professor. One of Titus's teachers, who eventually ascends to Headmaster of Gormenghast. In many respects, he is the standard absent-minded professor who falls asleep during his own class and plays with marbles. However, deep inside him there

1920-471: Is an outcast who becomes a feral child living in the wilderness surrounding Gormenghast. She is fierce and untameable, living only for herself, and takes her revenge on the Bright Carvers by mutilating their carvings. Believing that she is in every way the opposite of Gormenghast, Titus becomes infatuated with her. She is killed by a bolt of lightning. No: the face was more mask-like than expressive. It symbolised her way of life, not her immediate thoughts. It

2016-445: Is anything but pretty, she is considerably vain. She desperately desires to be admired and loved by men. She becomes romantically involved with Bellgrove. Vain as a child, thin as a stork's leg, and, in her black glasses, blind as an owl in daylight. She misses her footing on the social ladder at least three times a week, only to start climbing again, wriggling her pelvis all the while. She clasps her dead, white hands beneath her chin in

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2112-413: Is associated with higher morbidity and mortality. Other autonomic-related symptoms include excessive sweating, urinary incontinence , and sexual dysfunction . Neuropsychiatric symptoms (NPS) are common and range from mild disturbances to severe impairment, comprising abnormalities in cognition, mood, behavior, or thought which can interfere with daily activities, reduce quality of life, and increase

2208-403: Is caused by a distinct biomechanical process or if it is the manifestation of another cardinal sign of PD. Postural instability (PI) is typical in the later stages of the disease, leading to impaired balance and falls , and secondarily to bone fractures, thus, reduced mobility and quality of life. PI is absent in the initial stages and usually occurs 10–15 years after first diagnosis. Within

2304-507: Is considered one of the primary contributing factors for nigrostriatal neuron death in PD. When overexpressed or misfolded , it can form clumps on axon terminals and other neuronal structures, particularly its typical locations: the cytoplasm , mitochondria and nucleus . These aggregates eventually lead to the formation of Lewy bodies . Their precursors, known as oligomers , along with initial deposits called pale bodies, are believed to play

2400-502: Is estimated to be responsible for 1-2% of all cases of PD and 40% of familial cases. Additionally, mutations in the GBA1 gene, linked to Gaucher's disease , are found in 5–10 percent of PD cases. The GBA1 variant of genetic PD more commonly involves cognitive decline. Alpha-synuclein (aSyn), a protein encoded by SNCA gene , is thought to be primarily responsible Lewy body aggregation. ASyn activates ATM serine/threonine kinase ,

2496-610: Is finally hunted down and killed by Titus, who holds him responsible for the death of his sister, Fuchsia. His body gave the appearance of being malformed, but it would be difficult to say exactly what gave it this gibbous quality. Limb by limb it appeared that he was sound enough, but the sum of these several members accrued to an unexpectedly twisted total. His face was pale like clay and save for his eyes, masklike. These eyes were set very close together, and were small, dark red, and of startling concentration. Mr Flay: Lord Sepulchrave's personal servant, who believes in strictly holding to

2592-562: Is given as "Bernard", but this inconsistency is considered an error on Peake's part.) Although he appears at first to be foppish and weak, the doctor later shows himself to be both intelligent and courageous, and he plays an important role in defeating Steerpike. The doctor with his hyena laugh and his bizarre and elegant body, his celluloid face. His main defects? The insufferable pitch of his voice; his maddening laugh and his affected gestures. His cardinal virtue? An undamaged brain. Irma Prunesquallor: Doctor Prunesquallor's sister. Though she

2688-969: Is known to be present in up to 55 percent of PD patients. While it is responsible for most of paresthesia and pain in Parkingson Disease, its role in postural instability and motor impairment is poorly understood. Alterations in the autonomic nervous system , known as dysautonomia , are associated with a variety of symptoms such as gastrointestinal dysfunction , orthostatic hypotension , excessive sweating, or urinary incontinence. Gastrointestinal issues include constipation, impaired stomach emptying , immoderate production of saliva , and swallowing difficulty (prevalence up to 82 percent). Complications resulting from dysphagia include dehydration , malnutrition, weight loss, and aspiration pneumonia . All gastrointestinal features can be severe enough to cause discomfort, endanger health, and complicate disease management. Despite being related to each other,

2784-519: Is mainly based on signs and symptoms , usually motor-related, found via neurological examination , though medical imaging like neuromelanin MRI can support the diagnosis. Usual onset is in people over 60 years of age, of whom about one percent are affected. In those younger than 50, it is termed "early-onset PD". No cure is known; treatment aims to lessen symptoms. Initial treatment typically includes L-DOPA , MAO-B inhibitors , or dopamine agonists . As

2880-461: Is near-normal. Parkinson's disease (PD) is a neurodegenerative disease affecting both the central and peripheral nervous systems , characterized by the loss of dopamine -producing neurons in the substantia nigra region of the brain. It is classified as a synucleinopathy due to the abnormal accumulation of the protein alpha-synuclein , which aggregates into Lewy bodies within affected neurons. The loss of dopamine-producing neurons in

2976-422: Is often credited as the first fantasy of manners novel. The books have been translated into over twenty languages. The series consists of three books: Titus Groan (1946), Gormenghast (1950) and Titus Alone (1959). A short book, Boy in Darkness (1956), tells the story of a brief adventure by the young Titus away from Gormenghast, although it does not name the castle. Peake had intended to write

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3072-412: Is reached. Gormenghast Mountain is said to be so large that from the castle it looks at most a few miles distant, whereas in fact it is a day's ride away on horseback. However, this is contradicted by events within the story, when various characters are able to travel on foot to the castle and back within a single day. Given that it is surrounded on three sides by watery regions, it is not implausible that

3168-548: Is slightly cleverer than Clarice, their thoughts and motivations run along the same lines. Both crave political power and bitterly resent Gertrude, who they believe has robbed them of their rightful place in the hierarchy of Gormenghast. Their witless desire for the adulation they believe due to them by inheritance and their thirst for revenge against their brother's consort lead them to become Steerpike's pawns. She and her sister were dressed in purple with gold buckles at their throats by way of brooches, and another gold buckle each at

3264-428: Is the most common presenting sign and may appear at rest as well as during intentional movement with a frequency between 4–6  hertz (cycles per second). PD tremor tends to occur in the hands, but can affect other parts of the body, such as legs, arms, tongue, or lips, as well. It is often described as " pill-rolling ", the tendency of the index finger and thumb to touch and perform a circular movement that reminds of

3360-439: Is unconnected to the main story. Titus's character is one of yearning for freedom and the romance of being an ordinary person without the restrictions and responsibilities of the Earldom and the tradition that comes with it. As for Titus, he was almost grown now to his full height. But he was of an odd highly-strung nature -- sullen and excitable by turns. Strong as need be for his years, he was more apt to have his energy sapped by

3456-672: The autonomic or sensory nervous system, mood , behavior, sleep patterns, and cognition. Non-motor symptoms may precede the onset of motor symptoms by up to 20 years. These include constipation, anosmia , mood disorders , and REM sleep behavior disorder among others. In general, motor symptoms such as postural instability and gait abnormalities tend to appear as the disease progresses. Four motor symptoms are considered as cardinal signs in PD: tremor, bradykinesia, rigidity, and postural instability, collectively known as parkinsonism . However, other motor-associated symptoms are common. Tremor

3552-587: The central nervous system that affects both the motor and non-motor systems of the body. The symptoms usually emerge slowly, and, as the disease progresses, non-motor symptoms become more common. Usually symptoms include tremors , slowness of movement , rigidity , and difficulty with balance , collectively known as parkinsonism . Parkinson's disease dementia , falls and neuropsychiatric problems such as sleep abnormalities , psychosis , mood swings , or behavioral changes may also arise in advanced stages. Most cases of Parkinson's disease are sporadic , but

3648-590: The dopaminergic system which plays a central role in motor control . Three major pathways connect the basal ganglia to other brain areas: direct, indirect, and hyperdirect pathway, all part of the cortico-basal ganglia-thalamo-cortical loop . The direct pathway projects from the neocortex to putamen or caudate nucleus of the striatum, which sends inhibitory GABAergic signals to substantia nigra pars reticulata (SNpr) and internal globus pallidus (GPi). This inhibition reduces GABAergic signaling to ventral lateral (VL) and ventral anterior (VA) nuclei of

3744-507: The speculative fiction community and mainstream literary critics. The series has been included in Fantasy: The 100 Best Books , Modern Fantasy: The 100 Best Novels and 100 Must Read Fantasy Novels as one of the greatest fantasy works of the twentieth century. Literary critic Harold Bloom has praised the series as the best fantasy novels of the 20th century and one of the greatest sequences in modern world literature. Gormenghast

3840-478: The thalamus , thereby promoting their projections to the motor cortex . The indirect pathway projects inhibition from striatum to external globus pallidus (GPe), reducing its GABAergic inhibition of the subthalamic nucleus , pars reticulata and internal globus pallidus. This reduction in inhibition allows the subthalamic nucleus to excite internal globus pallidus and pars reticulata, which in turn inhibit thalamic activity, thereby suppressing excitatory signals to

3936-524: The "Castles", as they are known (to distinguish them from the Bright Carvers), are all commoners, they are nevertheless highly socially stratified, from the socially respectable Dr. Prunesquallor and the Professors to the lowly Grey Scrubbers, whose sole job is to clean the walls of the kitchen. However lowly the position of the "Castles" may be, they consider themselves to be far superior to

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4032-547: The 100th anniversary of Peake's birth. Gormenghast is a remote and reclusive earldom dominated by the huge Castle Gormenghast at its centre, and ruled by the noble family of Groan since time immemorial. The earldom derives its name from Gormenghast Mountain, and is isolated from the outside world by inhospitable regions on each side of it. To the North are marshy wastelands, to the South are grey salt marshes (and presumably then

4128-452: The Bright Carvers who live outside the castle walls. Steerpike : A youthful outsider, beginning as a kitchen boy, who worms his way into the hierarchy of Gormenghast for his own personal gain. Ruthlessly murderous, with a Machiavellian , highly intelligent and methodical mind, and a talent for manipulation, he can appear charming and sometimes even noble. But due to his fundamentally evil nature, he has natural personal enmity with Titus. He

4224-500: The Master of Ritual, and taking his place, but he is eventually unmasked as a traitor and murderer . The castle is flooded by a rainstorm , and in a watery duel with Titus, Steerpike is killed, leaving the way clear for Titus to reign. However, his desire to leave Gormenghast is now overwhelming, Titus flees the castle for the wider world beyond Gormenghast Mountain. The story follows Titus as he travels far from Gormenghast and finds

4320-501: The Overlook Press edition of Titus Alone ( ISBN   0-87951-427-2 ) and in the omnibus volume ( ISBN   0-87951-628-3 ). In the 1970s, Peake's widow Maeve Gilmore wrote her version of Titus Awakes , which she called Search Without End . The Peake family announced the discovery of this book in 2010, and it was published by The Overlook Press as Titus Awakes: The Lost Book of Gormenghast in 2011 to coincide with

4416-620: The abstracted girl in order to ease herself, or to bury the wrinkled prune of her face in Fuchsia's side. Alone in her small room again, she lies upon her bed and bites her minute knuckles. Sourdust: The Master of Ritual when the series begins. He is the one who coordinates the various arcane rituals that make up daily life in Gormenghast. After his death in the Library Fire, his position is taken up by his son Barquentine. His beard

4512-419: The all but palpable odor of the day's bellytimber. The arrogance of this fat head exudes itself like an evil sweat. Nannie Slagg: An ancient wrinkled doll-like 'dwarf' who nurses the infant Titus and Fuchsia before him. Nervous, self-pitying, child-like and lacking both mental agility and emotional comprehension, her life has been spent in service to the revered mores of Gormenghast. When called upon to perform

4608-457: The bed there swayed the shadows of four birds. Between them vacillated an enormous head. This umbrage was cast by her ladyship, the 76th Countess of Groan. She was propped against several pillows and a black shawl was draped around her shoulders. Her hair, a very dark red color of great luster, appeared to have been left suddenly while being woven into a knotted structure on the top of her head. Thick coils still fell about her shoulder or clustered on

4704-487: The birth of the eponymous Titus, as the heir to the throne of the House of Groan, and finishes just over a year later with his "Earling" or formal investiture as the seventy-seventh Earl of Groan, after the untimely death of his father Sepulchrave . As Titus is only an infant in this novel, he plays a minor role. The main plot therefore follows the somewhat bizarre inhabitants of Gormenghast Castle, and in particular chronicles

4800-647: The castle walls each morning. Their sole obsession is the carving of beautiful wooden sculptures, brightly painted, which they present to the Groans on a particular day each year in June. Only three of these carvings are chosen by the Earl of Gormenghast to be kept and the rest are burnt. Fierce rivalry exists between the Carvers to present the best carvings, and their lives are dominated by this and by their own long-held feuds and grudges against each other. The Bright Carvers are

4896-608: The ceremonies accorded to her role, the combination of her reverence for the House, her intrinsic inferiority complex and simple concern for the comfort of the children render her muddled and terrfied. With her charges, she is prone to dramas of wounded feelings but her devotion, and loving nature, means she is the only figure of affection to the young Titus and Fuschia. ... she is so minute, so frightened, so old, so querulous, she neither could, nor would, head any procession, even on paper. Her peevish cry goes out: "Oh, my weak heart! How could they?" and she hurries to Fuchsia either to smack

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4992-451: The characteristic reduced facial expression known as "masked face" or hypomimia . Rigidity , also referred to as rigor or "stiffness", is the increased resistance during passive mobilization of a limb affecting up to 89 percent of cases. It usually occurs after onset of tremor and bradykinesia on one or both sides of the body and can lead to muscle or joint pain as the disease progresses. As of 2024, it remains unclear whether rigidity

5088-457: The daughter of the scientist who runs the factory, and who grows to hate Titus and sets out to destroy him. This novel is more randomly plotted than its two predecessors, without a strong lead character or a fixed setting. A heavily edited first edition was published in 1959; a fuller version compiled by Langdon Jones from Peake's early drafts was issued in 1970 and forms the basis for all subsequent editions. Peake populated his imaginary world with

5184-478: The disease progresses, these medications become less effective and produce a side effect marked by involuntary muscle movements . Diet and certain forms of rehabilitation have shown some effectiveness at improving symptoms. Deep brain stimulation has been used to reduce severe motor symptoms when drugs are ineffective. There is little evidence for treatment of the non-movement-related symptoms, such as sleep disturbances and mood instability. The average life expectancy

5280-405: The disease. Neuronal cell death has been linked to noumerous mechanisms, with the most prominent being the misfolding and aggregation of alpha-synuclein , oxidative stress , neuroinflammation , ferroptosis , mitochondrial dysfunction , and gut dysbiosis. Alpha-synuclein (aSyn), a protein involved in synaptic vesicle trafficking , intracellular transport , and neurotransmitter release ,

5376-610: The early pharmaceutical technique of manually making pills. Despite it being the most noticeable sign, tremor is present in only about 70–90 percent of cases. Bradykinesia is often considered the most important feature of Parkinson's disease and is also present in atypical parkinsonism. It describes difficulties in motor planning , beginning, and executing, resulting in overall slowed movement with reduced amplitude which affects sequential and simultaneous tasks. Hence, it interferes with daily activities such as dressing, feeding and bathing. Facial muscles involved in bradykinesia lead to

5472-401: The end of hatpins which they wore through their gray hair in order apparently to match their brooches. Their faces, identical to the point of indecency, were quite expressionless, as though they were the preliminary layouts for faces and were waiting for sentience to be injected. Alongside the ruling Groan family there is a large population within the castle who service its daily needs. Although

5568-409: The entire region can be flooded, as described in the second book, Gormenghast . At the centre of the earldom is the vast, largely deserted castle , whose remaining inhabitants centre their lives on the ritual surrounding the ruling family of Groan. The castle is described as being like an immense island of stone, its every outline familiar to the inhabitants, who know "every bay, inlet and headland of

5664-470: The exact mechanism of these symptoms remains unknown. Orthostatic hypotension is the sustained drop of blood pressure by at least 20 mmHg systolic or 10 mmHg diastolic within the first three minutes after raising to an upright position that can be seen in 30–50 percent of cases. Low blood pressure can impair the perfusion of organs situated above the heart, particularly the brain, resulting in lightheadedness . This can eventually lead to fainting and

5760-456: The exact neurobiological mechanism, and therefore possible connections with other symptoms, remains unknown. Transformation of the sensory nervous system can lead to changes in sensation that include an impaired sense of smell , disturbed vision , pain, and paresthesia . Problems with visuospatial function may arise and lead to difficulties in facial recognition and perception of the orientation of drawn lines. Peripheral neuropathy

5856-402: The excess of his imagination than of his body. Lord Sepulchrave : 76th Earl and Titus's father. He is a melancholy man who feels shackled by his duties as Earl, although he never questions them. His only escape is reading. However, when the castle's Library is burnt down, he is driven insane and comes to believe that he is one of the death-owls that live in the abandoned Tower of Flints. ...

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5952-399: The fire, they are now under Steerpike's power. A subplot involves the feud between Sepulchrave's loyal servant Flay and the chef Swelter, which ends in a fight to the death. The second book follows Titus from the age of seven to seventeen. As the 77th earl and lord of Gormenghast, he dreads the life of pre-ordained ritual that stretches before him. His desire for freedom is awakened by

6048-547: The first book of the series, the son of Sepulchrave and Gertrude, and is an infant throughout the whole of Titus Groan . He grows up and reaches young adulthood in the second book Gormenghast , which ends with him leaving Gormenghast after defeating Steerpike in battle. In the third book, Titus Alone , Titus discovers a world outside of Gormenghast where the castle and its inhabitants are unknown. Titus also features in another book called Boy in Darkness , which appears to take place during his youth in Gormenghast, but which

6144-409: The first three years after disease onset, PI may indicate atypical parkinsonism. Together with bradykinesia and rigidity, it is responsible for the typical gait characterized by short shuffling steps and forward-flexed posture . Other common motor signs include a slurred and quiet voice, and handwriting that progressively becomes smaller . This latter may occur prior to other typical symptoms, but

6240-461: The flooding of the castle and hunt for Steerpike, but once those threats have passed she retreats back into her isolated world. According to Sepulchrave's sisters, the Ladies Cora and Clarice, Gertrude is of common blood and not of the noble bloodline of the Groans. As the candles guttered or flared so the shadows moved from side to side, or up and down the wall, and with those movements behind

6336-408: The general population. Apathy is characterized by emotional indifference and arises in about 46 percent of cases. Diagnosis is difficult, as it may become indistinct from symptoms of depression. Anxiety disorders develop in around 43 percent of cases. The most common are panic disorder , generalized anxiety disorder , and social anxiety disorder . Anxiety is known to cause deterioration in

6432-460: The great stone island of the Groans, of its sheer cliffs, of its crumbling outcrops, the broken line of the towers". Dominating the ivy -covered, crumbling castle is the highest tower, the Tower of Flints, which is inhabited by great numbers of owls . The castle is so huge that most of the inhabitants do not venture outside except for ceremonies. Outside the castle, clustered under the northern walls,

6528-469: The high hope of hiding the flatness of her chest. Abiatha Swelter: The fat, sadistic head chef of Gormenghast. His profound hatred for Flay leads him to attempt his murder; however, he is killed by his intended victim. Abiatha Swelter, who wades in a slug-like illness of fat through the humid ground mists of the Great Kitchen. From bowls as big as baths, there rises and drifts like a miasmic tide

6624-526: The initial motor symptoms. Individual presentation of symptoms vary, although most of people affected by PD show an altered circadian rhythm at some point of disease progression. PD is associated with a variety of skin disorders that include melanoma , seborrheic dermatitis , bullous pemphigoid , and rosacea . Seborrheic dermatitis is recognized as a premotor feature that indicates dysautonomia and demonstrates that PD can be detected not only by changes of nervous tissue , but tissue abnormalities outside

6720-465: The most common NPS and occurs in nearly half of all patients. It features low mood and lack of pleasure and is more prevalent in women. The diagnosis can be challenging since some symptoms of depression such as psychomotor retardation , memory problems, or altered appetite, share similarities with psychiatric signs caused by PD. It may result in suicidal ideation which is more prevalent in PD. Nonetheless, suicidal attempts themselves are lower than in

6816-682: The motor cortex. The hyperdirect pathway is an additional glutamatergic pathway that projects from the frontal lobe to subthalamic nucleus, modulating basal ganglia activity with rapid excitatory input. The striatum and other basal ganglia structures contain D1 and D2 receptor neurons that modulate the previously described pathways. Consequently, dopaminergic dysfunction in these systems can disrupt their respective components— motor , oculomotor , associative , limbic , and orbitofrontal circuits (each named for its primary projection area)—leading to symptoms related to movement, attention, and learning in

6912-528: The nervous system as well. As of 2024, the underlying cause of PD is unknown, yet is assumed to be influenced primarily by an interaction of genetic and environmental factors. Nonetheless, the most significant risk factor is age with a prevalence of 1 percent in those aged over 65 and approximately 4.3 percent in age over 85. Genetic components comprise SNCA , LRRK2 , and PARK2 among others, while environmental risks include exposure to pesticides or heavy metals . Timing of exposure factor may influence

7008-571: The ocean), to the East are quicksands and the tideless sea, and to the West are knuckles of endless rock. To the West also lies the claw-like Gormenghast Mountain, with the Twisted Woods and Gormenghast River at its foot. East of them are escarpments described as "an irregular tableland of greeny-black rock, broken and scarred and empty", then desolate swamp before the vicinity of the castle

7104-434: The onset of PD. Risk is increased by co-exposure to, for example, glyphosate and MPTP . Harmful heavy metals include mainly manganese , iron , lead , mercury , aluminium , and cadmium . On the other hand, magnesium shows neuroprotective features. Other chemical compounds include trichloroethylene and MPTP . Traumatic brain injury is also strongly implicated as a risk factor. Additionally, although

7200-496: The pillows like burning snakes. Her eyes were of the pale green that is common among cats. They were large eyes, yet seemed, in proportion to the pale area of her face, to be small. The nose was big enough to appear so in spite of the expanse that surrounded it. The effect which she produced was one of bulk.... Lady Fuchsia Groan : Titus's older sister. Fanciful, impatient, immature, and self-absorbed, she can also be impulsively warm and caring. She at first resents Titus but develops

7296-437: The progression or severity of certain stages. However, caffeine and nicotine exhibit neuroprotective features, hence lowering the risk of PD. About 85 percent of cases occur sporadic , meaning that there is no family history. PD, in a narrow sense, can be seen as a genetic disease; heritability is estimated to lie between 22 and 40 percent, across different ethnicities. Around 15 percent of diagnosed individuals have

7392-462: The rest of Gormenghast. Instead, she spends her time locked away in her bedroom, in the company of a legion of cats and birds, the only beings toward which she shows affection. However, when required to use her intelligence she turns out to be one of the cleverest people in the castle, when (along with Flay and the doctor) she recognizes and investigates the worrying changes transpiring in Gormenghast. She demonstrates unexpected leadership qualities during

7488-400: The rise to power of Steerpike , a scheming kitchen boy . Steerpike successfully destroys the existing order of the castle by inciting the power-hungry and shunned twin sisters of Sepulchrave, Cora and Clarice, to burn Sepulchrave's beloved library. This event drives Sepulchrave into madness and eventually into taking his own life. Although Cora and Clarice are not exposed as the perpetrators of

7584-400: The risk for admission to a nursing home . Some of them, such as depression and anxiety, are known to precede characteristic motor signs by up to several years and may herald the development of PD, while most of them worsen as the disease progresses. Research indicates that patients with more severe motor symptoms are at higher risk for any NPS. Conversely, NPS can worsen PD. Depression is

7680-403: The role of Master of Ritual. He is lame in one leg, hideous, and unbelievably dirty. He is a consummate misanthrope who abuses and insults everybody he meets, and who cares only for the rigid application of the laws and traditions of Gormenghast. He makes the grievous error of allowing Steerpike to become his assistant. The lynch-pin son of the dead Sourdust, by name Barquentine, Master of Ritual,

7776-581: The rules of Gormenghast. Nevertheless, he is not completely hard-hearted and cares a great deal for Titus and Fuchsia. He is eventually exiled from Gormenghast for throwing one of the Countess's cats at Steerpike. However, he secretly keeps an eye on the doings in the castle, and plays a crucial role in Steerpike's eventual unmasking as a traitor. Mr Flay appeared to clutter up the doorway as he stood revealed, his arms folded.... It did not look as though such

7872-459: The same time, the world he encounters is so different from his old home that he begins to doubt that Gormenghast ever really existed. Titus is helped by mysterious inhabitants he meets, such as Muzzlehatch, the owner of a zoo , who drives a shark -shaped car and becomes a friend and mentor . He is also helped by Muzzlehatch's former lover, Juno, who in turn becomes Titus's lover for a brief period. However, Titus also becomes involved with Cheeta,

7968-468: The sight of his foster sister, known only as "The Thing", a feral child who lives in the woods of Gormenghast (due to her mother being banished as an outcast) and who terrorizes the Bright Carvers, the inhabitants of the mud dwellings outside the castle walls. Her life of wild freedom makes him realise that an existence is possible other than the rigid formalities and ritual of the castle. Meanwhile, Steerpike continues his rise to power by killing Barquentine,

8064-422: The stonework, and drowns unconscious in the floodwaters surrounding the Castle. ... a girl of about fifteen with long, rather wild black hair. She was gauche in movement and in a sense ugly of face, but with how small a twist might she not suddenly have become beautiful. Her sullen mouth was full and rich -- her eyes smoldered. A yellow scarf hung loosely around her neck. Her shapeless dress was flaming red. For all

8160-416: The straightness of her back, she walked with a slouch. Cora and Clarice Groan: Titus's aunts (sisters of Sepulchrave) are identical twins. They experienced spasms and 'fits' in their youth that temporarily paralysed the left-hand sides of their bodies. Their personalities appear indistinguishable and their combined conduct and conversation devoid of insight or intelligence — although Cora believes that she

8256-767: The substantia nigra initially presents as movement abnormalities, leading to Parkinson's further categorization as a movement disorder . In 30% of cases, disease progression leads to the cognitive decline known as Parkinson's disease dementia (PDD). Alongside dementia with Lewy bodies , PDD is one of the two subtypes of Lewy body dementia . The four cardinal motor symptoms of Parkinson's— bradykinesia (slowed movements), postural instability , rigidity , and tremor —are called parkinsonism . These four symptoms are not exclusive to Parkinson's and can occur in many other conditions, including HIV infection and recreational drug use . Neurodegenerative diseases that feature parkinsonism but have distinct differences are grouped under

8352-495: The symptoms of PD. Parkinson's disease psychosis (PDP) is present in around 20 percent of cases and comprises hallucinations , illusions and delusions . It is associated with dopaminergic drugs used to treat the motor symptoms, higher morbidity, mortality, a decrease in health-promoting behaviors, and longer nursing home stays. Additionally, it correlates with depression and may herald onset of dementia in advanced stages. Unlike other psychotic forms, PDP typically presents with

8448-425: The time of his death in 1968. The book was completed by Peake's widow Maeve Gilmore in the 1970s, but was not published until 2011 after it was discovered by their family. Although the first two installments do not contain any overtly fantastical elements, Gormenghast is almost unanimously categorised as fantasy because of the atmosphere and pseudo-medieval setting. The series has received widespread acclaim from

8544-520: The title Gormenghast . If an internal link led you here, you may wish to change the link to point directly to the intended article. Retrieved from " https://en.wikipedia.org/w/index.php?title=Gormenghast&oldid=931463345 " Category : Disambiguation pages Hidden categories: Short description is different from Wikidata All article disambiguation pages All disambiguation pages Gormenghast (series) Gormenghast ( / ˈ ɡ ɔːr m ə n ɡ ɑː s t / )

8640-453: The umbrella of Parkinson-plus syndromes or, alternatively, atypical parkinsonian disorders. Parkinson's disease can result from genetic factors or be idiopathic , in which there is no clearly identifiable cause. The latter, also called sporadic Parkinson's, makes up some 85–90% of cases. The defining symptoms affect the motor system and include tremor , bradykinesia , rigidity , and postural instability . Other symptoms may affect

8736-509: The underlying cause is unknown, melanoma is documented to be associated with PD. Low levels of urate in the blood are associated with an increased risk while Helicobacter pylori infection can prevent the absorption of some drugs, including L-DOPA . Main pathological feature is cell death of dopamine -releasing neurons within, among other regions, the basal ganglia , more precisely pars compacta of substantia nigra and partially striatum , thus impeding nigrostriatal pathway of

8832-710: The use of dopamine agonists. Cognitive disturbances can occur in early stages or before diagnosis, and increase in prevalence and severity with duration of the disease. Ranging from mild cognitive impairment to severe Parkinson's disease dementia , they feature executive dysfunction , slowed cognitive processing speed , and disrupted perception and estimation of time. Sleep disorders are common in PD and affect about two thirds of all patients. They comprise insomnia , excessive daytime sleepiness (EDS), restless legs syndrome (RLS), REM sleep behavior disorder (RBD), and sleep-disordered breathing (SDB), many of which can be worsened by medication. RBD may begin years prior to

8928-461: Was accomplished by these cracking sounds, one per step, which might be likened to the breaking of dry twigs. Dr Alfred Prunesquallor: The castle's resident physician. He is an eccentric individual with a high-pitched laugh and a grandiose wit which he uses on the castle's less intelligent inhabitants. Despite his acid tongue, he is an extremely kind and caring man who also is greatly fond of Fuchsia and Titus. (Several times, Prunesquallor's first name

9024-423: Was knotted and the hairs that composed it were black and white. His face was very lined, as though it had been made of brown paper that had been crunched by some savage hand before being hastily smoothed out and spread over the tissues. His eyes were deep set and almost lost in the shadows cast by his fine brow, which for all its wrinkles, retained a sweeping breadth of bone. Barquentine : Follows his father into

9120-668: Was something of the major prophet about him. But his eyes were disappointing. They made no effort to bear out the promise of the other features, which would have formed the ideal setting for the kind of eye that flashes with visionary fire. Mr Bellgrove's eyes didn't flash at all. Also known as the Mud Dwellers or the Outer Dwellers, the Bright Carvers live directly outside the castle walls, crammed closely together in hovels of mud and straw. Their lives are hard and monotonous, and they live solely on jarl root (a kind of tree growing in Gormenghast forest), and crusts of bread lowered down from

9216-426: Was the colour of a robin's egg, and as closely freckled. Her hair was black and thick but she had hacked it away, a little above her shoulders. Her rounded neck was set straight upon her shoulders, and was so flexible that the liquid ease with which she turned it was reminiscent of a serpent. Parkinson%27s disease Parkinson's disease ( PD ), or simply Parkinson's , is a neurodegenerative disease of mainly

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