Hysterical paralysis after spinal surgery.

This letter is to report and discuss two cases of psychogenic paralysis after spinal surgery in order to increase the vigilance and assist in the diagnosis and treatment of this uncommon disorder. The medical records for two middle-aged men who presented complete loss of extremities function after spinal surgery were reviewed retrospectively. None had a history of a previous hysterical seizure. Both of the patients' symptoms and signs differ from the correct anatomic pattern of a neurological deficit. Both of them spontaneously recovered and discharged from the hospital uneventful eventually. The orthopedic surgeons must recognize hysterical paralysis to avoid unnecessary surgery. A heightened awareness of a nonanatomic functional deficit on physical examination could help to reduce frustration and delay in diagnosis associated with this disorder. Rapid recovery should be expected, but the surgeon should administrate proper treatment.