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PubMed1986

Hysterical paralysis in the upper extremity of chronic pain patients.

The patient with chronic pain who develops the conversion symptom of hysterical paralysis in the upper extremity can be treated successfully by rehabilitation medicine services, using a shaping behavioral program. Four case reports illustrate the management of this condition and the basic ingredients for such a program are outlined. The approach is based upon learning principles and experience with conversion reactions affecting gait. Treatment outcome often is related directly to the care and skill with which psychological assessment is performed and to the coordinated effort of the various team members.

Adult↗
PubMed1985

Visual feedback of vocal intensity in the treatment of hysterical aphonia.

This case report describes the successful though temporary removal of a hysterical aphonic symptom in a 49-year-old male patient by using visual feedback of changes in vocal intensity. Following symptom removal the patient experienced considerable emotional distress due to a number of factors. His aphonia returned and has proven resistant to subsequent intervention. At a 1-year follow-up his condition was found to be unchanged. The case is discussed in relation to the common controversy over the wisdom of symptomatic treatment for hysterical reactions, and a practical means of resolving the disagreement is considered.

Aphonia↗
PubMedDate not supplied

Adult onset of stuttering as a presenting sign in a parkinsonian-like syndrome: a case report.

Stuttering onset in adulthood is rare. With no prior history of stuttering or demonstrable neurological insult, diagnosis is often that of a conversion reaction. Stuttering as the first sign of a parkinsonian-like syndrome in extrapyramidal disease has only been reported once in the previous 30 years (Koller, 1983). The present case study differs from and builds upon the case reports in the literature, and describes a 29-year-old white male who began stuttering purportedly secondary to psychological stress. The fluency evaluation revealed severe stuttering characterized by multiple repetitions and/or blocks, with 20 or more repetitions per word routinely noted during both conversational speech and oral reading. No starters or secondary stuttering characteristics, no specific word fears or avoidances, and no situational fears were exhibited. The subsequent neurological examination found resting tremor in hands and legs, lingual fasciculations, gait imbalance, and numbness and tingling of the hands and feet, all of which were progressive in nature. Rehabilitation initially focused on fluency therapy, but then included psychiatric therapy, and finally medical intervention. Fluency and psychiatric therapies were unsuccessful in eliminating stuttering. Following a diagnosis of parkinsonian-like syndrome, medical intervention with carbidopa-levodopa resulted in dramatic improvement of motor, sensory, and fluency symptoms. It is important to consider extrapyramidal disease as an etiological factor in patients with adult onset of stuttering.

Adult↗
PubMed1980

Hysteria.

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Adult↗