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Munchausen's disorder: a case of a factitious neurological emergency

G R Wise, E C Shuttleworth

    The Journal of Clinical Psychiatry
    |June 1, 1978
    PubMed

    Insights

    Physicians can detect malingering by understanding neurologic disease pathophysiology. A cholinergic solution can help identify pharmacologic pupillary paralysis, distinguishing it from simulated neurological emergencies.

    Area of Science:

    • Neurology
    • Toxicology

    Background:

    • Dilated pupils unresponsive to light are a critical neurological sign.
    • Simulating neurological signs can lead to unnecessary and hazardous medical procedures.

    Observation:

    • A case of Munchausen's Disorder involving attempted simulation of a neurological emergency is presented.
    • The patient's attempts to feign a neurological emergency were unsuccessful.

    Findings:

    • A comprehensive understanding of neurological disease pathophysiology aids in identifying malingering.
    • Pharmacologic pupillary paralysis, unlike simulated conditions, often does not respond to cholinergic solutions.

    Implications:

    • Accurate diagnosis is crucial to prevent iatrogenic harm from unnecessary procedures.
    • Physicians must be vigilant in differentiating genuine neurological emergencies from simulated ones.

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