OBJECTIVE: New neurologic deficit after spinal surgery is a rare complication that must be promptly diagnosed and treated to reduce the risk of permanent neurologic disability. SUMMARY OF BACKGROUND DATA: A 37-year-old woman underwent left laminotomy and L5-S1 diskectomy for the treatment of L5-S1 disc herniation. She was found to be normal after recovery from anesthesia but loss of muscle power in the left lower limb after 1 h. METHODS: Surgical exploration was performed; no obvious hemorrhage or compression because of hematoma was observed. After the exploration, the muscle power recovered but deteriorated after 10 h. RESULTS: Re-exploration did not yield any specific findings. In view of the normal electrophysiological and anatomic findings, a psychiatric evaluation confirmed the diagnosis of conversion paralysis with major depression disorder. CONCLUSION: Normal somatosensory-evoked potentials or motor-evoked potentials in a patient denying sensation of stimuli offer objective evidence of the psychogenic nature of the para/tetraplegia. This report describes a case in which psychopathology interfered with the outcome of a frequently used procedure for a well-defined, chronic, painful condition.
OBJECTIVE: New neurologic deficit after spinal surgery is a rare complication that must be promptly diagnosed and treated to reduce the risk of permanent neurologic disability. SUMMARY OF BACKGROUND DATA: A 37-year-old woman underwent left laminotomy and L5-S1 diskectomy for the treatment of L5-S1 disc herniation. She was found to be normal after recovery from anesthesia but loss of muscle power in the left lower limb after 1 h. METHODS: Surgical exploration was performed; no obvious hemorrhage or compression because of hematoma was observed. After the exploration, the muscle power recovered but deteriorated after 10 h. RESULTS: Re-exploration did not yield any specific findings. In view of the normal electrophysiological and anatomic findings, a psychiatric evaluation confirmed the diagnosis of conversion paralysis with major depression disorder. CONCLUSION: Normal somatosensory-evoked potentials or motor-evoked potentials in a patient denying sensation of stimuli offer objective evidence of the psychogenic nature of the para/tetraplegia. This report describes a case in which psychopathology interfered with the outcome of a frequently used procedure for a well-defined, chronic, painful condition.
Authors: Hasan Büyükaslan; Sultan Basmacı Kandemir; Mehmet Asoğlu; Halil Kaya; Mehmet Tahir Gökdemir; İbrahim Fatih Karababa; Fatih Güngörmez; Fethiye Kılıçaslan; Emin Şavik Journal: Neuropsychiatr Dis Treat Date: 2016-07-13 Impact factor: 2.570