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Charcot in the ICU: functional tetraplegia after surgery
  1. Kristen M Scheitler1,
  2. Cynthia R Robin2,
  3. E F M Wijdicks3
  1. 1Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA
  2. 2Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA
  3. 3Neurology, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Eelco F M Wijdicks, Department of Neurology, Rochester, MN 55905, USA; wijde{at}mayo.edu

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
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Footnotes

  • Contributors KMS 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.

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