Skip to main content
SpringerLink
Log in

Hysterical paralysis after spinal surgery

  • Letter to the Editor
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

This letter is to report and discuss two cases of psychogenic paralysis after spinal surgery in order to increase the vigilance and assist in the diagnosis and treatment of this uncommon disorder. The medical records for two middle-aged men who presented complete loss of extremities function after spinal surgery were reviewed retrospectively. None had a history of a previous hysterical seizure. Both of the patients’ symptoms and signs differ from the correct anatomic pattern of a neurological deficit. Both of them spontaneously recovered and discharged from the hospital uneventful eventually. The orthopedic surgeons must recognize hysterical paralysis to avoid unnecessary surgery. A heightened awareness of a nonanatomic functional deficit on physical examination could help to reduce frustration and delay in diagnosis associated with this disorder. Rapid recovery should be expected, but the surgeon should administrate proper treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Heruti RJ, Reznik J, Adunski A, Levy A, Weingarden H, Ohry A (2002) Conversion motor paralysis disorder: analysis of 34 consecutive referrals. Spinal Cord 40:335–340. doi:10.1038/sj.sc.3101307

    Article  PubMed  CAS  Google Scholar 

  2. Hurwitz TA (2004) Somatization and conversion disorder. Can J Psychiatry 49:172–178

    PubMed  Google Scholar 

  3. Baker JH, Silver JR (1987) Hysterical paraplegia. J Neurol Neurosurg Psychiatry 50:375–382

    Article  PubMed  CAS  Google Scholar 

  4. Maue FR (1986) Functional somatic disorders. Key diagnostic features. Postgrad Med 79:201–210

    PubMed  CAS  Google Scholar 

  5. Letonoff EJ, Williams TR, Sidhu KS (2002) Hysterical paralysis: a report of three cases and a review of the literature. Spine (Phila Pa 1976) 27:E441–E445. doi:10.1097/01.BRS.0000029268.16070.D8

    Article  Google Scholar 

  6. Yugue I, Shiba K, Ueta T, Iwamoto Y (2004) A new clinical evaluation for hysterical paralysis. Spine (Phila Pa 1976) 29:1910–1913 (discussion 1913)

    Google Scholar 

  7. Heruti RJ, Levy A, Adunski A, Ohry A (2002) Conversion motor paralysis disorder: overview and rehabilitation model. Spinal Cord 40:327–334. doi:10.1038/sj.sc.3101308

    Article  PubMed  CAS  Google Scholar 

  8. Atan C, Seckin U, Bodur H (2007) Hysterical paralysis. Rheumatol Int 27:873–874. doi:10.1007/s00296-006-0290-5

    Article  PubMed  Google Scholar 

  9. Oulis P, Kokras N, Papadimitriou GN, Masdrakis VG (2009) Adjunctive low-dose amisulpride in motor conversion disorder. Clin Neuropharmacol 32:342–343. doi:10.1097/WNF.0b013e3181b20144

    Article  PubMed  Google Scholar 

  10. Silver FW (1996) Management of conversion disorder. Am J Phys Med Rehabil 75:134–140

    Article  PubMed  CAS  Google Scholar 

  11. Crimlisk HL, Bhatia K, Cope H, David A, Marsden CD, Ron MA (1998) Slater revisited: 6 year follow up study of patients with medically unexplained motor symptoms. BMJ 316:582–586

    Article  PubMed  CAS  Google Scholar 

  12. Guz H, Doganay Z, Ozkan A, Colak E, Tomac A, Sarisoy G (2004) Conversion and somatization disorders; dissociative symptoms and other characteristics. J Psychosom Res 56:287–291. doi:10.1016/S0022-3999(03)00069-2

    Article  PubMed  Google Scholar 

  13. Binzer M, Kullgren G (1998) Motor conversion disorder. A prospective 2- to 5-year follow-up study. Psychosomatics 39:519–527

    Article  PubMed  CAS  Google Scholar 

  14. Fishbain DA, Rosomoff HL (2003) Hysterical paralysis: a report of three cases and a review of the literature. Spine (Phila Pa 1976) 28:1906. doi:10.1097/01.BRS.0000084876.60951.AA

    Article  Google Scholar 

  15. Sleth JC (2010) Hysterical conversion mimicking acute paraplegia after spinal anaesthesia. Int J Obstet Anesth 19:126–127. doi:10.1016/j.ijoa.2009.07.007

    Article  PubMed  Google Scholar 

  16. Yi S, Yoon do H, Kim KN, Kim SH, Shin HC (2006) Postoperative spinal epidural hematoma: risk factor and clinical outcome. Yonsei Med J 47:326–332

    Article  PubMed  Google Scholar 

  17. Fountas KN, Kapsalaki EZ, Nikolakakos LG, Smisson HF, Johnston KW, Grigorian AA, Lee GP, Robinson JS Jr (2007) Anterior cervical discectomy and fusion associated complications. Spine (Phila Pa 1976) 32:2310–2317. doi:10.1097/BRS.0b013e318154c57e

    Article  Google Scholar 

  18. Jang JW, Lee JK, Seo BR, Kim SH (2010) Spontaneous resolution of tetraparesis because of postoperative cervical epidural hematoma. Spine J 10:e1–e5. doi:10.1016/j.spinee.2010.09.021

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedics, Changzheng Hospital, The Second Military Medical University, 415 Fengyang Road, Huangpu District, Shanghai, 200003, People’s Republic of China

    Liang Zhu, Bin Ni & Qunfeng Guo

Authors
  1. Liang Zhu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bin Ni
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Qunfeng Guo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bin Ni.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Zhu, L., Ni, B. & Guo, Q. Hysterical paralysis after spinal surgery. Rheumatol Int 32, 4077–4078 (2012). https://doi.org/10.1007/s00296-011-2257-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-011-2257-4

Keywords

Search

Navigation