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."
Department of Medicine, Nassau County Medical Center, East Meadow, NY 11554, USA.
A M
AM
Karnik
M S
MS
Hussain
D003291:Conversion Disorder / Q000175:diagnosis* / Q000503:physiopathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008487:Medical History Taking; D008875:Middle Aged; D010264:Paraplegia / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D010808:Physical Examination; D016138:Walking / Q000502:physiology; D014910:Wheelchairs