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Pseudohysterical hemiparesis.

Yutaka Tanaka¹, Martin L Albert, Masao Miyazaki

¹Neurology, Tanaka Clinic, Ikoma-Gun, Nara, Japan. EZZ05540@nifty.com

The Journal of Nervous and Mental Disease

|November 29, 2007

Summary

This summary is machine-generated.

This study identified pseudohysterical hemiparesis in four patients with normal brain imaging. Reduced frontal lobe blood flow was observed, suggesting a neurological basis for these symptoms.

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Area of Science:

Neurology
Neuroimaging
Psychiatry

Background:

Hysterical hemiparesis is a diagnosis of exclusion, often associated with psychological distress.
Patients may receive psychiatric medication without significant improvement.
Standard neuroimaging like MRI often appears normal in these cases.

Observation:

Four patients diagnosed with hysterical hemiparesis presented with normal MRI scans.
Antidepressant or antianxiety medications provided no relief.
Single photon emission computed tomography (SPECT) was used for further evaluation.

Findings:

SPECT revealed decreased regional cerebral blood flow in frontal cortical areas.
The areas of reduced blood flow corresponded to the patients' specific neurological deficits.
Neurological treatment led to improvement in all four cases.

Implications:

Reduced frontal lobe blood flow may be the underlying cause of "pseudohysterical hemiparesis."
This suggests a potential organic basis for conditions previously attributed solely to psychological factors.
Further research into cerebral blood flow may refine diagnoses and treatments for functional neurological disorders.