Vandermeulen L, Van Melkebeke L, Bollen O, Remans J
Tijdschr Psychiatr. 2022;64(10):696-700.
We describe a case of a patient with a functional coma ,and give a systemic review of literature. Functional coma is an extremely rare disorder with only 21 described cases in the literature. The disease is linked to a conversion disorder or a dissociative disorder and is predominantly found in females. Predisposing factors are a history of sexual or physical abuse, psychiatric disorders, previous episodes of functional coma, and recent surgery with general anesthesia. Several clinical signs are suggestive for the diagnosis, however none of them is sufficiently sensitive or specific. Therefore, functional coma remains an exclusion diagnosis. Vital signs must be normal, just as a routine blood examination, an electroencephalogram and imaging of the central nervous system. The most important differential diagnosis are catatonia, factitious disorder, and malingering. Spontaneous recovery can be expected after a duration of about 45 minutes to 4 days.
我们描述了一例功能性昏迷患者的病例，并对相关文献进行了系统回顾。功能性昏迷是一种极为罕见的疾病，文献中仅记载了21例。该疾病与转换障碍或分离性障碍有关，主要见于女性。诱发因素包括性虐待或身体虐待史、精神疾病、既往功能性昏迷发作史以及近期的全身麻醉手术。有几种临床体征提示该诊断，但均不够敏感或特异。因此，功能性昏迷仍是一种排除性诊断。生命体征必须正常，常规血液检查、脑电图和中枢神经系统影像学检查结果也应正常。最重要的鉴别诊断包括紧张症、做作性障碍和诈病。预计在持续约45分钟至4天后可自发恢复。
