癔症性截瘫
Hysterical paraplegia.
作者信息
Baker J H, Silver J R
出版信息
J Neurol Neurosurg Psychiatry. 1987 Apr;50(4):375-82. doi: 10.1136/jnnp.50.4.375.
Between 1944 and 1984 20 patients were admitted to a spinal injuries centre with a diagnosis of traumatic paraplegia. They subsequently walked out and the diagnosis was revised to hysterical paraplegia. A further 23 patients with incomplete traumatic injuries, who also walked from the centre, have been compared with them as controls. The features that enabled a diagnosis of hysterical paraplegia to be arrived at were: They were predominantly paraplegic, There was a high incidence of previous psychiatric illness and employment in the Health Service or allied professions, Many were actively seeking compensation. The physical findings were a disproportionate motor paralysis, non anatomical sensory loss, the presence of downgoing plantar responses, normal tone and reflexes. They made a rapid total recovery. In contrast, the control traumatic cases showed an incomplete recovery and a persistent residual neurological deficit. Investigations apart from plain radiographs of the spinal column were not warranted, and the diagnosis should be possible on clinical grounds alone.
1944年至1984年间，有20名患者因创伤性截瘫诊断被收治入一家脊髓损伤中心。他们随后能够行走，诊断被修订为癔症性截瘫。另外23名创伤不完全损伤患者也从该中心康复出院，已将他们作为对照与上述患者进行比较。能够得出癔症性截瘫诊断的特征有：他们主要为截瘫，既往有精神疾病且在卫生服务机构或相关行业工作的发生率较高，许多人积极寻求赔偿。体格检查结果为运动麻痹程度不成比例、非解剖学部位的感觉丧失、跖反射向下、肌张力和反射正常。他们完全迅速康复。相比之下，对照的创伤病例恢复不完全且存在持续的残余神经功能缺损。除脊柱平片外无需进行其他检查，仅根据临床情况就应能够做出诊断。
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