Case Report

Paraplegia Diagnosed by a New Physical Sign

Authors: ASHOK M. KARNIK, MD, FRCP (London), MOHAMMAD S. HUSSAIN, MD

Abstract

Clinical diagnosis is a process of logical deduction from the data gathered by history and physical examination. When organic causes of an illness have been ruled out, a diagnosis of “functional disorder” or “conversion reaction” is considered. Cost of care of such patients can be enormous, especially when a large number of investigations are done to find an organic illness, which does not really exist. In such cases, a positive and early diagnosis of a conversion reaction can save needless tests and much distress to the patient. This report describes a case of paraplegia that was investigated for years before a diagnosis of conversion reaction was firmly made, based on a novel observation. We believe that we describe here a new physical sign, which can be used to diagnose “hysterical paraplegia.”

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References