Hintze U, Runge U, Hachenberg T, Wendt M
Klinik für Anästhesiologie und Intensivmedizin, Ernst-Moritz-Arndt-Universität Greifswald.
Anasthesiol Intensivmed Notfallmed Schmerzther. 1998 Nov;33(11):753-5. doi: 10.1055/s-2007-994846.
Two cases are described in which a dissociative stupor originating from conversion neurosis simulated a coma following a sustained trauma. At first both patients showed no response to being addressed or to pain stimuli. They presented an upward eye gaze deviation, cardiorespiratory functions were stable. Following extensive diagnostic procedures revealing no organic cause for the clinical symptoms, the diagnosis of a hysterical consciousness disorder was stated. Symptoms of conversion neuroses include lacking call response, gait disorder, seizure-like conditions and strength diminution in one or more extremities. In these cases suspicious facts are the absence of injuries (for example by falling down or tongue bite during a dissociative attack), eye gaze deviation and the phenomenon that, when the patient's arm is raised above the head and let fall, it never hits the face but glides down beside the body.
本文描述了两例因转换性神经症引发的分离性木僵病例，其症状类似持续创伤后的昏迷。起初，两名患者对他人呼喊及疼痛刺激均无反应。他们表现出双眼上视偏斜，心肺功能稳定。经过广泛的诊断程序，未发现导致临床症状的器质性病因，遂诊断为癔症性意识障碍。转换性神经症的症状包括缺乏言语应答、步态障碍、癫痫样发作以及一个或多个肢体力量减弱。在这些病例中，可疑的情况包括无受伤迹象（例如在分离性发作时摔倒或咬伤舌头）、眼凝视偏斜以及当患者手臂举过头顶再放下时，手臂不会打到脸部而是沿身体一侧滑落的现象。
