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Full-Endoscopic Transforaminal Approach for Lumbar Discectomy
Published on: September 8, 2023
Conversion paralysis after surgery for lumbar disc herniation
Ming-Kai Hsieh1, Chen-Nen Chang, Mei-Chun Hsiao
1Department of Orthopaedic Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.
Spine
|April 17, 2010
Summary
Post-spinal surgery, conversion paralysis can occur, presenting as limb weakness despite normal neurological exams. Early psychiatric evaluation is crucial for accurate diagnosis and management.
Area of Science:
- Neurology
- Psychiatry
- Spinal Surgery
Background:
- A 37-year-old woman underwent L5-S1 diskectomy for herniated disc.
- Postoperatively, she developed left lower limb muscle power loss.
Observation:
- Initial surgical exploration revealed no hematoma or compression.
- Muscle power temporarily recovered but then deteriorated.
- Electrophysiological and anatomical findings were normal.
Findings:
- Psychiatric evaluation diagnosed conversion paralysis with major depression disorder.
- Normal somatosensory-evoked potentials (SSEPs) and motor-evoked potentials (MEPs) indicated a psychogenic cause.
Implications:
- Highlights the importance of considering psychogenic causes for neurologic deficits after spinal surgery.
- Normal SSEPs/MEPs can objectively support a diagnosis of psychogenic paralysis.
- Psychopathology can impact surgical outcomes for chronic pain conditions.
