Karnik A M, Hussain M S
Department of Medicine, Nassau County Medical Center, East Meadow, NY 11554, USA.
South Med J. 2000 Jul;93(7):724-5.
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."
临床诊断是一个根据病史和体格检查所收集的数据进行逻辑推理的过程。当排除了疾病的器质性病因后，会考虑诊断为“功能性障碍”或“转换反应”。这类患者的护理成本可能非常高昂，尤其是在进行大量检查以寻找实际上并不存在的器质性疾病时。在这种情况下，对转换反应做出积极且早期的诊断可以避免不必要的检查，并极大减轻患者的痛苦。本报告描述了一例截瘫病例，在基于一项新的观察结果最终确诊为转换反应之前，该病例被研究了数年。我们认为我们在此描述了一种新的体征，可用于诊断“癔症性截瘫”。
