Hysterical paralyses as disorders of action

Area of Science:

• Neurology
• Psychiatry
• Philosophy of Mind

Background:

• Hysterical paralysis presents diagnostic challenges, requiring assessment of patient intent.
• Current objective criteria are insufficient to distinguish hysterical from feigned disorders.

Purpose of the Study:

• To analyze the nature of hysterical paralysis.
• To question the objective basis for differentiating hysterical and feigned conditions.
• To explore the role of 'will' and intention in these disorders.

Main Methods:

• Clinical observation of voluntary motor inconsistency in hysterical paralysis.
• Analysis of the characteristics of action disorders.
• Review of psychodynamic and conscious maintenance factors.
• Consideration of preliminary functional neuroimaging findings.

Main Results:

• Hysterical paralyses exhibit voluntary motor inconsistency, affecting specific actions while sparing others using the same muscles.
• These conditions are disorders of action, linked to abnormalities in mind, will, or intention.
• Maintenance of hysterical paralysis requires conscious attention and can remit with sedation/distraction.

Conclusions:

• The distinction between hysterical and feigned disorders lacks objective justification.
• Hysterical paralysis represents a disordered 'will', potentially distinguishable via neuroimaging.
• Future research may elucidate the pathophysiology and functional anatomy of these conditions.