DOI QR코드

DOI QR Code

A Review of Diagnostic Methods on Neurologic Symptoms by Non-organic Causes: A Case of a Patient

비기질적 원인에 의한 신경학적 증상 감별법에 대한 고찰: 사례를 중심으로

  • Cho, Min Kyoung (Department of Oriental Internal Medicine, Pusan National University Korean Medicine Hospital) ;
  • Lim, Jung Hwa (Department of Oriental Neuropsychiatry, Pusan National University Korean Medicine Hospital) ;
  • Park, Seung Chan (Department of Oriental Internal Medicine, Pusan National University Korean Medicine Hospital) ;
  • Kim, Do Hyung (Department of Oriental Internal Medicine, Pusan National University Korean Medicine Hospital) ;
  • Kim, So Yeon (Department of Oriental Internal Medicine, Pusan National University Korean Medicine Hospital) ;
  • Choi, Jun Yong (Department of Oriental Internal Medicine, Pusan National University Korean Medicine Hospital) ;
  • Han, Chang Woo (Department of Oriental Internal Medicine, Pusan National University Korean Medicine Hospital) ;
  • Park, Seong Ha (Department of Oriental Internal Medicine, Pusan National University Korean Medicine Hospital) ;
  • Hong, Jin Woo (Department of Oriental Internal Medicine, Pusan National University Korean Medicine Hospital) ;
  • Kwon, Jung Nam (Department of Oriental Internal Medicine, Pusan National University Korean Medicine Hospital) ;
  • Lee, In (Department of Oriental Internal Medicine, Pusan National University Korean Medicine Hospital)
  • 조민경 (부산대학교 한방병원 한방내과) ;
  • 임정화 (부산대학교 한방병원 한방신경정신과) ;
  • 박승찬 (부산대학교 한방병원 한방내과) ;
  • 김도형 (부산대학교 한방병원 한방내과) ;
  • 김소연 (부산대학교 한방병원 한방내과) ;
  • 최준용 (부산대학교 한방병원 한방내과) ;
  • 한창우 (부산대학교 한방병원 한방내과) ;
  • 박성하 (부산대학교 한방병원 한방내과) ;
  • 홍진우 (부산대학교 한방병원 한방내과) ;
  • 권정남 (부산대학교 한방병원 한방내과) ;
  • 이인 (부산대학교 한방병원 한방내과)
  • Received : 2014.02.10
  • Accepted : 2014.02.28
  • Published : 2014.03.30

Abstract

Objectives: The objective of this study is to review the diagnostic methods of neurologic symptoms by non-organic causes. Methods: We experienced a case of a motor and sensory disturbance patient without abnormal findings in the diagnostic tests. Using this process, we became aware that it is important to remember some of the methods when treating patients who are suspicious of neurologic symptoms by non-organic causes. Results: First, we should perform a variety of diagnostic tests to exclude the organic causes. Second, we should persistently observe a consistency of the patient's symptoms and attitude. Finally, we should perform a neurological examination in order to acquire the objective physical findings. Conclusions: Because there are limitations in the methods above, we have to be aware of making a mistake regarding the disability by organic causes as that by non-organic causes.

Keywords

References

  1. Peveler R, Kilkenny L, Kinmonth AL. Medically unexplained physical symptoms in primary care: a comparison of self-report screening questionnaires and clinical opinion. J Psychosom Res. 1997;42(3):245-52. https://doi.org/10.1016/S0022-3999(96)00292-9
  2. Song JY. Current Issues in the Diagnosis of Malingering : Sensory and Motor Symptoms. Korean J Psychosom Med. 2004;12(2):103-21
  3. Neuropsychiatry textbook compilation committee colleges of Korean medicine in Korea. Korean medical neuropsychiatry. 1st Edition. Paju-si, Gyeonggi-do:Jipmoondang;2007, 504, 512
  4. Slater E T, Glithero E. A follow-up of patients diagnosed as suffering from "hysteria". J Psychosom Res. 1965;9(1):9-13 https://doi.org/10.1016/0022-3999(65)90004-8
  5. Stone J, Smyth R, Carson A, Lewis S, Prescott R, Warlow C, Sharpe M. Systematic review of misdiagnosis of conversion symptoms and “hysteria”. BMJ. 2005;331:989 https://doi.org/10.1136/bmj.38628.466898.55
  6. Smith HE, Rynning RE, Okafor C, Zaslavsky J, Tracy JI, Ratliff J, Harrop J, Albert T, Hilibrand A, Anderson G, Sharan A, Brown Z, Vaccaro AR. Evaluation of neurologic deficit without apparent cause: the importance of a multidisciplinary approach. J Spinal Cord Med. 2007;30(5):509-17 https://doi.org/10.1080/10790268.2007.11754585
  7. Adetunji B, Basil B, Mathews M, Williams A, Osinowo T, Oladinni O. Detection and management of malingering in a clinical setting. Prim Psychiatr. 2006;13(1):61-9
  8. Ziv I, Djaldetti R, Zoldan Y, Avraham M, Melamed E. Diagnosis of "non-organic" limb paresis by a novel objective motor assessment: the quantitative Hoover's test. J Neurol. 1998;245(12):797-802 https://doi.org/10.1007/s004150050289
  9. Sonoo M. Abductor sign: a reliable new sign to detect unilateral non-organic paresis of the lower limb. J Neurol. Neurosurg Psychiatry. 2004;75:121-5
  10. Yugue I, Shiba K, Ueta T, Iwamoto Y. A new clinical evaluation for hysterical paralysis. Spine. 2004;29(17):1910-3 https://doi.org/10.1097/01.brs.0000137055.55350.37
  11. Okun MS, Koehler PJ. Babinski's clinical differentiation of organic paralysis from hysterical paralysis: effect on US neurology. Arch Neurol. 2004;61(5):778-83 https://doi.org/10.1001/archneur.61.5.778
  12. Aziz S, Marwan N SABBAGH. Pseudoneurologic Syndromes: Recognition and Diagnosis. Am Fam Physician. 1998;57(10):2485-94
  13. Greer S, Chambliss L, Mackler L, Huber T. What physical exam techniques are useful to detect malingering? J Fam Pract. 2005;54(8):719-22
  14. Carson AJ, Ringbauer B, Stone J, McKenzie L, Warlow C, Sharpe M. Do medically unexplained symptoms matter? A prospective cohort study of 300 new referrals to neurology outpatient clinics. J Neurol Neurosurg Psychiatry. 2000;68(2):207-10 https://doi.org/10.1136/jnnp.68.2.207
  15. Rolak LA. Psychogenic sensory loss. J Nerv Ment Dis. 1988;176(11):686-7 https://doi.org/10.1097/00005053-198811000-00007