Article Text
Abstract
Functional neurological disorder is a condition in which a patient has physical findings that are not compatible with anatomical boundaries, have no structural substrate and are not representable of an established disease. General anaesthesia and surgery have been previously reported as precipitating factors for functional disorders and mostly involve dissociative (non-epileptic) seizures. We report a patient with no psychiatric history or prior abnormal examination who developed sudden onset functional tetraplegia and sensory disturbances immediately after elective surgery, and who was subsequently discharged home several days later after nearly complete resolution of neurologic deficits. We highlight the features of this syndrome, including its unique postoperative presentation, unusual resolution and absence of any identifiable psycho-dynamic mechanism. We also introduce the tripod sign as a useful clinical tool in identifying functional tetraplegia.
- COMA
- CONSCIOUSNESS
- CSF DYNAMICS
- STROKE
Statistics from Altmetric.com
Footnotes
Contributors KMS examined the patient and drafted the original manuscript. CRR examined the patient and reviewed the manuscript for content. EFMW supervised the first two authors, examined the patient, suggested research materials and reviewed the manuscript for content. All authors approved this final version for submission.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Data sharing statement All data are included in the manuscript.
Provenance and peer review Not commissioned; externally peer reviewed by Jon Stone, Edinburgh, UK.
Read the full text or download the PDF:
Other content recommended for you
- Functional weakness: clues to mechanism from the nature of onset
- New weakness in a critically ill patient
- Pain and functional neurological disorder: a systematic review and meta-analysis
- Recognising and explaining functional neurological disorder
- Functional weakness and sensory disturbance
- ‘Cryptogenic Drop Attacks’ revisited: evidence of overlap with functional neurological disorder
- Skeletal muscle channelopathies: a guide to diagnosis and management
- Functional movement disorder gender, age and phenotype study: a systematic review and individual patient meta-analysis of 4905 cases
- Specialist inpatient treatment for severe motor conversion disorder: a retrospective comparative study
- Functional neurological disorders: the neurological assessment as treatment