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04:46
A Novel Rescue Technique for Difficult Intubation and Difficult Ventilation
Published on: January 17, 2011
Recurrent psychogenic coma following tracheal stenosis repair
T J Meyers1, B W Jafek, A D Meyers
1Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Denver, USA.
Archives of Otolaryngology--Head & Neck Surgery
|November 11, 1999
Summary
Unexplained unconsciousness after anesthesia may stem from conversion disorder, not physical causes. A patient
Area of Science:
- Anesthesiology
- Psychiatry
- Neurology
Background:
- Differential diagnosis of unconsciousness post-anesthesia includes various medical and neurological conditions.
- Tracheal stenosis surgery can present unique post-operative challenges.
Observation:
- A 39-year-old woman experienced recurrent, prolonged unconsciousness after tracheal stenosis repair.
- Episodes occurred after endotracheal tube removal, with normal initial examinations.
- Patient history included depression, anxiety, and past abuse.
Findings:
- Medical, neurological, and radiological workups were consistently normal during unconscious episodes.
- Hypothesized diagnosis: conversion disorder triggered by psychological conflict related to past trauma.
- Unexplained unconsciousness resolved spontaneously, consistent with psychogenic etiology.
Implications:
- Highlights the importance of considering psychogenic causes in unexplained post-anesthesia unconsciousness.
- Suggests thorough psychological evaluation for patients with recurrent unexplained symptoms.
- Emphasizes the link between psychological trauma and physical manifestations.
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