The use of motor evoked potentials in the diagnosis of psychogenic quadriparesis a case study

Nobuhito Morota, Vedran Deletis, Kiril Kiprovski, Fred Epstein, Rick Abbott

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

We present a case illustrating the usefulness of motor evoked potentials (MEPs) in differentiating psychogenic from organic postoperative paralysis. Discussed is a 12-year-old girl who underwent surgery for the repair of a recurrent syringomyelia. On the 6 day after a proximal revision of her syringoperi- toneal shunt she returned to the hospital with deep quadriparesis, bowel and bladder incontinence, and complaining of severe headache. An MRI scan showed the syrinx to be collapsed, and removal of the shunt had no impact on her clinical symptoms. Repeat somatosensory evoked potentials (SEPs) showed no change in comparison to those obtained at the end of her preceding surgery. MEPs were normal for the lower extremities, a finding which is inconsistent with a severe upper motor neuron lesion. She was diagnosed with psychogenic paralysis, and fully recovered within 1 month. We propose that a neurophysiological evaluation including MEPs is useful in the differential diagnosis of psychogenic and organic motor weakness.

Original languageEnglish (US)
Pages (from-to)203-206
Number of pages4
JournalPediatric neurosurgery
Volume20
Issue number3
DOIs
StatePublished - Jan 1 1994
Externally publishedYes

Keywords

  • Motor evoked potentials
  • Psychogenic paralysis
  • Somatosensory evoked potentials
  • Syringomyelia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery
  • Clinical Neurology

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