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PubMed1994

The use of motor evoked potentials in the diagnosis of psychogenic quadriparesis. A case study.

We present a case illustrating the usefulness of motor evoked potentials (MEPs) in differentiating psychogenic from organic postoperative paralysis. Discussed is a 12-year-old girl who underwent surgery for the repair of a recurrent syringomyelia. On the 6 day after a proximal revision of her syringoperitoneal shunt she returned to the hospital with deep quadriparesis, bowel and bladder incontinence, and complaining of severe headache. An MRI scan showed the syrinx to be collapsed, and removal of the shunt had no impact on her clinical symptoms. Repeat somatosensory evoked potentials (SEPs) showed no change in comparison to those obtained at the end of her preceding surgery. MEPs were normal for the lower extremities, a finding which is inconsistent with a severe upper motor neuron lesion. She was diagnosed with psychogenic paralysis, and fully recovered within 1 month. We propose that a neurophysiological evaluation including MEPs is useful in the differential diagnosis of psychogenic and organic motor weakness.

Child↗
PubMed1981

Psychogenic retention of urine.

Psychogenic retention of urine (PRU) may manifest itself in different clinical forms which mimic a genuine organic disturbance. Three clinical examples are presented in which PRU appears as: (1) malingering; (2) an upper motor lesion inducing spastic closure of the bladder neck, and (3) an alteration of the sensory input, closely resembling sensory neuron damage. The urologist becomes involved in the treatment of these patients by the natural expression of the symptoms. The underlying psychogenic factor does not become evident until urodynamic investigations and often specific therapeutic steps have been undertaken. The urologic treatment sometimes appears helpful because the patients do not realise or refuse to accept the idea of a psychogenic cause and expect relief from the urologist. The latter should withdraw his involvement as soon as an organic cause has been excluded.

Adult↗
PubMed1986

Conversion hallucinations--a possible mental mechanism.

Hallucinations are a well-recognized phenomenon in a dissociative state. In reference to conversion states, sensations may be distorted or inhibited but overstimulation to the extent of hallucination has not yet been recognized. We wish to offer a hypothesis of conversion hallucinations based on two detailed case reports, with a possible mode of action and in combination with the cognitive and dissociative models.

Conversion Disorder↗
PubMed1991

True conversive hallucinations.

A case of true conversive hallucinations in a 19-year-old female soldier is described. This phenomenon is rare and should be distinguished from psychotic or dissociative states.

Adult↗
PubMed1984

Symptom formation.

The issue of symptom formation in patients is discussed in terms of evolution relating to cultures and changes in disease patterns. Determinants of symptoms depend upon a host of factors including the individual's developmental history and personality, the setting in which illness develops, the contemporary social status of the individual, the cognitive and affective state, and the resources based on learning that the individual has in coping and adapting to stressful situations threatening the stability of the organism.

Arousal↗