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At least 487 records · Page 27Linked to original sources
PubMed1989

Psychogenic tremors.

We diagnosed 24 patients, 9 men and 15 women ranging in age from 15 to 78 years, with clinically established or documented psychogenic tremors. Clinical presentations were unique, with complex tremors (often resting, postural, and kinetic), unusual temporal profiles (abrupt onset with a variable course), absence of other neurologic signs, inconsistent and incongruous symptomatology, selective disability with ability to perform some functions despite severe tremors, distractibility that lessens or abolishes tremor, atypical tremorgraphic recordings with changing amplitude and frequency, unusual handwriting and drawing specimens, presence of multiple undiagnosed somatizations, unresponsiveness to all treatments, absence of documented disease by laboratory or radiographic tests, presence of psychiatric disease, spontaneous remissions, or recovery with psychotherapy. We present criteria for the diagnosis of psychogenic tremor.

Adolescent↗
PubMed1987

Otolaryngologic cases of Munchausen's syndrome.

Münchausen syndrome (MS) is now a well recognized and demonstrated entity. This syndrome is characterized by patients who seek hospitalization and present factitious but usually well-rehearsed histories and symptoms. Five cases of MS, genuine by their ear-nose-throat-maxillofacial factitious signs, are presented. Two of the cases are related to the uncommon MS by proxy. In this subentity the parents fabricate pathological signs for their children. The psychodynamics and the clinical symptoms of our cases are described and the differential diagnoses of malingering, conversion disorders, and hypochondriasis are brought to attention.

Adult↗
PubMed2006

Different types of "dissociation" have different psychological mechanisms.

The term "dissociation" has been used to describe a wide range of psychological and psychiatric phenomena. The popular conception of dissociation describes it as a unitary phenomenon, with only quantitative differences in severity between the various dissociative conditions. More recently, it has been argued that the available evidence is more consistent with a model that identifies at least two distinct categories of dissociative phenomena-"detachment" and "compartmentalization"- that have different definitions, mechanisms and treatment implications (Holmes, Brown, Mansell, Fearon, Hunter, Frasquilho & Oakley 2005). This paper presents evidence for this bipartite model of dissociation, followed by definitions and descriptions of detachment and compartmentalization. Possible psychological mechanisms underlying these phenomena are then discussed, with particular emphasis on the nature of compartmentalization in conversion disorder, hypnosis, dissociative amnesia and dissociative identity disorder.

Amnesia↗
PubMed1998

Anatomy and clinical significance of the horizontal cleft in the infrapatellar fat pad of the knee: MR imaging.

OBJECTIVE: The purpose of this study was to determine the prevalence and nature of a horizontal cleft in the posterior aspect of Hoffa's infrapatellar fat pad and to show pathologic processes involving this cleft. MATERIALS AND METHODS: Fifty consecutive MR imaging examinations of the knee were evaluated for the presence and appearance of a cleft in the infrapatellar fat pad. Examples of abnormalities involving the cleft were collected from additional MR studies. MR imaging, gross dissection, and histologic examination of a cadaveric knee were also performed to evaluate the anatomy and histology of the cleft. RESULTS: The cleft in the infrapatellar fat pad was revealed on MR imaging in 45 of 50 knees and had a variable shape, either linear (82%), pipe-shaped (7%), or globular-shaped (11%). Joint effusion or anterior cruciate ligament tear did not affect the appearance of the cleft. The cleft was located anterior to the distal insertion of the anterior cruciate ligament on the tibia. At gross dissection of the cadaveric knee, the roof of the cleft was formed by the ligamentum mucosum (infrapatellar plica), and the cleft was lined with synovium. The prospective evaluation of additional MR imaging examinations of the knee revealed pathologic entities of the cleft such as ganglion cysts, loose bodies, nodular synovitis, and amyloid. CONCLUSION: A horizontal cleft located in the posterior aspect of the infrapatellar fat pad is a common and normal MR imaging finding with a prevalence of 90%. The horizontal cleft is lined with synovium and its roof is formed by the ligamentum mucosum (infrapatellar plica). This cleft communicates with the knee joint. A distended cleft can form a prominent recess mimicking pathologic processes; conversely, disorders can arise in the cleft.

Adipose Tissue↗
PubMed1992

Carbon monoxide, amnesia and hyperbaric oxygen therapy.

A case of carbon monoxide poisoning, initially misdiagnosed as conversion disorder, is presented. Cognitive deficits demonstrated at the time of psychiatric assessment were successfully reversed by hyperbaric oxygen therapy despite the 1 week delay. The clinical manifestations of carbon monoxide poisoning and the rationale for and timing of hyperbaric oxygen therapy are discussed. Emphasis is placed on the need for a high index of suspicion for carbon monoxide poisoning in the clinical situation of profound memory disturbance.

Adult↗
PubMed1996

Posterior fossa lesions associated with neuropsychiatric symptomatology.

We reviewed 7 cases with posterior fossa structural abnormalities (3 tumors, 2 megacisterna magna and 2 Dandy-Walker syndrome) presenting with neuropsychiatric symptomatology. Derangement in the balance of dopamine, serotonin and noradrenergic networks has been implicated in the pathogenesis of schizophrenia, affective and even personality disorders. Disruption of the cerebellar output to mesial dopaminergic areas, locus coeruleus and raphe nuclei, or deafferentation of the thalamolimbic circuits by a cerebellar lesion may lead to behavioral changes. Seven patients (pts) (comprising 4 men and 3 women with mean age 22 years) were diagnosed as suffering from psychosis (2 pts), major depression (1 pt), personality disorders (2 pts) and somatoform disorders (2 pts) (DSM-IV criteria). Brain CT scan (7 pts) and MRI (4 pts) revealed tumors of the posterior fossa (2 pts), megacisterna magna (2 pts) and Dandy-Walker variant (2 pts). In one patient a IVth ventricle tumor was removed in childhood.

Adult↗
PubMedDate not supplied

Insulinoma in Iran: a 20-year review.

BACKGROUND: The time between onset of symptoms of insulinoma to diagnosis ranges from 10 days to more than 20 years. To help physicians make an earlier diagnosis, we defined the clinical, imaging and paraclinical characteristics of insulinoma in cases from seven referral hospitals in Iran over two decades. METHODS: The medical records of 68 cases with biochemical or histological evidences of insulinoma were reviewed. RESULTS: More males were affected (53%). The mean age at diagnosis was 39 +/- 15.3 years. The mean duration of symptoms was 39.9 +/- 59.3 months. Eighty-four percent of patients had been initially misdiagnosed as cereberovascular accident (CVA), epilepsy, conversion disorder, and others). Neuroadrenergic symptoms were observed in 89.6% and and neuroglycopenic symptoms in 97% of patients. Mean diameter of tumours was 2.9 cm (range, 1 cm to 8.5 cm). Of 52 pathologically confirmed cases of insulinoma, 43 tumours (87.8%) were single and 49 (94.2%) were benign. Fifty-five patients had undergone surgery, with a successful outcome in 44 (80%). CONCLUSION: The high incidence of neuroglycopenic symptoms suggest the clinical impression of insulinoma when patients present with a suggestive clinical syndrome. The clinical impression is essential to decrease the frequent delay in the diagnosis of insulinoma.

Adolescent↗
PubMed2000

Paraplegia diagnosed by a new physical sign.

Clinical diagnosis is a process of logical deduction from the data gathered by history and physical examination. When organic causes of an illness have been ruled out, a diagnosis of "functional disorder" or "conversion reaction" is considered. Cost of care of such patients can be enormous, especially when a large number of investigations are done to find an organic illness, which does not really exist. In such cases, a positive and early diagnosis of a conversion reaction can save needless tests and much distress to the patient. This report describes a case of paraplegia that was investigated for years before a diagnosis of conversion reaction was firmly made, based on a novel observation. We believe that we describe here a new physical sign, which can be used to diagnose "hysterical paraplegia."

Conversion Disorder↗
PubMed1975

Hysteria.

Explore the source record for details and available documents.

Abreaction↗
PubMed1998

[HLA-DRB alleles polymorphism in susceptibility to asthma in Beijing Chinese].

OBJECTIVES: To investigate whether susceptibility or resistance to asthma associated with HLA-DRB alleles and analyze the relationship between HLA-DRB genes and clinical phenotype of asthma (TIgE, sIgE, BHR). METHODS: Using PCR-SSP(sequence-specific primer polymerase chain reaction), we tested the frequency distribution of HLA-DRB alleles in 50 asthmatic patients and 80 healthy volunteers from Beijing China. All patients had their serum TIgE, IgE antibody specific to house dust mite measured by RAST, bronchial responsiveness assessed by methacholine bronch-provocation (if FEV1% > or = 70%), and broncho-dilation measurement by inhaling salbutamol. RESULTS: There was significantly increased gene frequency of alleles DR6(13), DR52 in asthmatics compared with normal controls (17% vs 4.3%, P < 0.01; 50% vs 17.5%, P < 0.01), and RR was 7.55 and 4.7 respectively. The frequency of DR2(15), DR51 was lower in asthmatics than in controls (7% vs 18% P < 0.01; 2% vs 33.8% P < 0.01). The percentage of HLA haplotype DR6(13)-DR52 was higher in asthmatics than in healthy volunteers (20% vs 4%, P < 0.01, RR 6.4). 70% of individuals sharing DR6(13) gene and 56% of subjects carrying DR52 gene had elevated serum d1 sIgE antibody (> or = +4). There was no relationship between HLA-DRB alleles and total IgE, BHR. CONCLUSIONS: Alleles DR6(13), DR52 are significantly implicated in their susceptibility to asthma, at least they may be closely associated with this disorder. Conversely DR2(15), DR51 alleles might confer protection against asthma. Positive associations between DR6(13), DR52 and IgE response to d1 allergen are noted. HLA-DRB genes are particularly involved in regulating human atopic immune response.

Adult↗
PubMed2001

Physically manifested illness in children and adolescents. A biobehavioral family approach.

This article presents a family systems approach to the assessment and treatment of children and adolescents with physically manifested illness. A biobehavioral continuum of psychologically and physically manifested disease is offered to replace the false dichotomy of organic versus psychological illness. The Biobehavioral Family Model, an empirically validated model of the mutual influence of family relational patterns and childhood illness, organizes the treatment approach. The Family Process Assessment Protocol provides a method of diagnosing the child's illness in the context of family relational functioning. Two cases, a child with conversion disorder and a child with asthma, illustrate this approach. Additional family systems approaches are referenced in a table with citations.

Adolescent↗
PubMed1975

Limb coordinations during locomotion in amygdalar, rubral and funicular cats.

The registration of the step phases and the relations between them for all of the four limbs were described in the amygdalar, rubral and funicular cats. The evident changes in motor behavior observed after damage of the amygdala and red nucleus did not result from coordination disorders. Conversely, the damage of the medial part of the lateral funiculus in the dorsally hemisected spinal cord disturbed the coordination between fore and hind limbs.

Amygdala↗
PubMed2002

Factitious disorders in civil litigation: twenty cases illustrating the spectrum of abnormal illness-affirming behavior.

Physical symptoms are commonly alleged in civil litigation. In some instances these symptoms are originally produced by psychological factors and antedate the alleged injury being claimed as a tort. These cases reflect abnormal illness-affirming behavior. Factitious physical disorders represent a special category of these individuals because they produce their signs and symptoms consciously. This article reviews common features of 20 cases of factitious disorder in which the patients were involved in civil litigation. Attention to these factors can facilitate differential diagnosis, which can lead to improved understanding of causation and appropriate clinical interventions. The authors discuss how the actions of such individuals often shift along the entire spectrum of abnormal illness-affirming behavior over time.

Adult↗