Portaro Simona, Milardi Demetrio, Naro Antonino, Chillura Antonio, Corallo Francesco, Quartarone Angelo, Calabrò Rocco Salvatore
IRCCS Centro Neurolesi "Bonino-Pulejo", Messina, Italy.
Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.
Psychiatry Investig. 2018 Apr;15(4):428-431. doi: 10.30773/pi.2017.10.16.2. Epub 2018 Mar 30.
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.
无意识出现且与已知病理生理机制或解剖通路不符的神经症状属于转换障碍（CD）。CD的诊断基于临床病史以及排除导致严重痛苦或社会和职业功能受损的躯体疾病。在CD的一个亚组，即功能性肌无力（FW）中，影响肢体的症状可能持续存在，从而导致肢体功能永久性或暂时性丧失。物理治疗、药物治疗、催眠疗法和重复经颅磁刺激（rTMS）已被提议作为FW-CD的治疗策略。在此，我们报告一名30岁男性，表现为下肢功能性轻瘫，通过与多学科方法（包括心理和性学咨询）相关的延长r-TMS方案，并经步态分析监测，获得了客观且稳定的积极效果。我们推测，我们的rTMS方案与多学科方法相结合可能是改善FW-CD的合适治疗策略。
