Psychological Factors Affecting Physical Conditions, Somatoform Disorders, Conversion, Dissociation, and Factitious Syndromes
An 11-year-old girl was admitted to the pediatrics service for inability to walk due to paralysis of her left lower extremity. One morning, upon awakening, she found that she was unable to move her left thigh and leg and had to stay in bed. On admission, she had flaccid paralysis of her thigh and legs as well as stocking-like hypoesthesia. All labs and imaging studies were within normal limits except for slight anemia. The Hoover sign (see Chapter 29) was positive. The patient told the psychiatric consultant that she and her family had recently moved from another city, and she had enrolled in a new school where she had no friends. She missed her old friends, particularly a boy with whom she was close, which she kept a secret from her parents. As she talked about how much she missed her old school, she felt that she was beginning to feel some more sensation in her left leg and thigh. The consultant recommended physical therapy. In 2 days’ time, the patient recovered enough movement and sensation in her left extremity that she was able to be discharged. In the meanwhile, she and her parents agreed that she could phone her old friends frequently. A psychiatric follow-up appointment was made.
KeywordsIrritable Bowel Syndrome Psychological Factor Transient Global Amnesia Psychiatric Syndrome Disuse Atrophy
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