Cécité postopératoire : un cas de conversion hystérique après une chirurgie du rachis

We report a case of conversion paralysis after cervical spine arthroplasty performed in a 45-year-old woman to treat cervico-brachial neuralgia due to a left-sided C6-C7 disc herniation. Upon awakening from the anaesthesia, she had left hemiplegia sparing the face, with normal sensory function. Magnetic resonance imaging (MRI) of the brain ruled out a stroke. MRI of the spinal cord showed artefacts from the cobalt-chrome prosthesis that precluded confident elimination of mechanical spinal cord compression. Surgery performed on the same day to substitute a cage for the prosthesis ruled out spinal cord compression, while eliminating the source of MRI artefacts. Findings were normal from follow-up MRI scans 1 and 15days later, as well as from neurophysiological testing (electromyogram and motor evoked potentials). The deficit resolved fully within the next 4days. A psychological assessment revealed emotional distress related to an ongoing divorce. The most likely diagnosis was conversion paralysis. Surgeons should be aware that conversion disorder might develop after a procedure on the spine, although the risk of litigation requires re-operation. Familiarity with specific MRI sequences that minimise artefacts can be valuable. A preoperative psychological assessment might improve the detection of patients at high risk for conversion disorder.

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Conversion paralysis after cervical spine arthroplasty: A case report and literature review

Boudissa

Castelain

Boissière

et al. 2015

Orthopaedics & Traumatology: Surgery & Research

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Paralysie de conversion dans les suites d’une arthroplastie du rachis cervical : cas clinique et revue de la littérature

Boudissa

Castelain

Boissière

et al. 2015

Revue de Chirurgie Orthopédique et Traumatologique

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Cécité postopératoire : un cas de conversion hystérique après une chirurgie du rachis

Cited by 2 publications

References 6 publications

Conversion paralysis after cervical spine arthroplasty: A case report and literature review

Conversion paralysis after cervical spine arthroplasty: A case report and literature review

Paralysie de conversion dans les suites d’une arthroplastie du rachis cervical : cas clinique et revue de la littérature

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