Chasing the Chameleon: Psychogenic Paraparesis Responding to Non-Invasive Brain Stimulation.
- Author:
Simona PORTARO
1
;
Demetrio MILARDI
;
Antonino NARO
;
Antonio CHILLURA
;
Francesco CORALLO
;
Angelo QUARTARONE
;
Rocco Salvatore CALABRÒ
Author Information
- Publication Type:Case Report
- Keywords: Functional weakness; Conversion disorder; Repetitive Transcranial Magnetic Stimulation (r-TMS); Multidisciplinary approach; Treatment strategies
- MeSH: Brain*; Conversion Disorder; Counseling; Diagnosis; Drug Therapy; Extremities; Gait; Humans; Hypnosis; Lower Extremity; Male; Neurologic Manifestations; Paraparesis*; Transcranial Magnetic Stimulation
- From:Psychiatry Investigation 2018;15(4):428-431
- CountryRepublic of Korea
- Language:English
- Abstract: Neurologic symptoms that develop unconsciously and are incompatible with known pathophysiologic mechanisms or anatomic pathways belong to Conversion Disorder (CD). CD diagnosis is based on the clinical history and the exclusion of physical disorders causing significant distress or social and occupational impairment. In a subgroup of CD, called functional weakness (FW), symptoms affecting limbs may be persistent, thus causing a permanent or transient loss of limb function. Physiotherapy, pharmacotherapy, hypnotherapy and repetitive transcranial magnetic stimulation (rTMS) have been proposed as treatment strategies for FW-CD. Herein, we report a 30 year-old male, presenting with lower limb functional paraparesis, having obtained positive, objectively, and stable effects from a prolonged r-TMS protocol associated to a multidisciplinary approach, including psychological and sexuological counseling, and monitored by gait analysis. We postulate that our rTMS protocol, combined with a multidisciplinary approach may be the proper treatment strategy to improve FW-CD.
