[Disseminated encephalomyelitis--a mask for conversion neurosis?]. 1992

R Wölfle, and P König
Krankenhaus Stiftung Maria Ebene, Frastanz.

A female patient, aged 24 years, with a case history of 9 years duration, 4 admissions to a neurological and 3 to a psychiatric ward was first diagnosed as multiple sclerosis. Diagnosis was based on neurological symptoms, whereas repeated laboratory values, electrophysiological measurements, CT and MRI scans were equivocal. Nevertheless this initial diagnosis profoundly influenced the further course of the illness: the patient ending up with an invalidity-pension. At that period she was admitted for her first psychiatric hospitalization after attempted suicide. Extensive investigations led to revision of the former diagnosis and Adlerian psychotherapy effected a remission of practically all neurological symptoms, so that the woman could be reintegrated socially and in her profession. Differential-diagnosis of multiple sclerosis is revised and the necessity of extensive, also psychodynamic, case-investigation is stressed, as is the need of consequent psychotherapy effected by a medical therapist.

UI MeSH Term Description Entries
D009103 Multiple Sclerosis An autoimmune disorder mainly affecting young adults and characterized by destruction of myelin in the central nervous system. Pathologic findings include multiple sharply demarcated areas of demyelination throughout the white matter of the central nervous system. Clinical manifestations include visual loss, extra-ocular movement disorders, paresthesias, loss of sensation, weakness, dysarthria, spasticity, ataxia, and bladder dysfunction. The usual pattern is one of recurrent attacks followed by partial recovery (see MULTIPLE SCLEROSIS, RELAPSING-REMITTING), but acute fulminating and chronic progressive forms (see MULTIPLE SCLEROSIS, CHRONIC PROGRESSIVE) also occur. (Adams et al., Principles of Neurology, 6th ed, p903) MS (Multiple Sclerosis),Multiple Sclerosis, Acute Fulminating,Sclerosis, Disseminated,Disseminated Sclerosis,Sclerosis, Multiple
D009460 Neurologic Examination Assessment of sensory and motor responses and reflexes that is used to determine impairment of the nervous system. Examination, Neurologic,Neurological Examination,Examination, Neurological,Examinations, Neurologic,Examinations, Neurological,Neurologic Examinations,Neurological Examinations
D010348 Patient Care Team Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient. Health Care Team,Interdisciplinary Health Team,Medical Care Team,Multidisciplinary Care Team,Multidisciplinary Health Team,Healthcare Team,Care Team, Health,Care Team, Medical,Care Team, Multidisciplinary,Care Team, Patient,Care Teams, Health,Care Teams, Patient,Health Care Teams,Health Team, Interdisciplinary,Health Team, Multidisciplinary,Healthcare Teams,Interdisciplinary Health Teams,Medical Care Teams,Multidisciplinary Care Teams,Multidisciplinary Health Teams,Patient Care Teams,Team, Health Care,Team, Healthcare,Team, Interdisciplinary Health,Team, Medical Care,Team, Multidisciplinary Care,Team, Multidisciplinary Health,Team, Patient Care,Teams, Interdisciplinary Health
D011575 Psychoanalytic Therapy A form of psychiatric treatment, based on Freudian principles, which seeks to eliminate or diminish the undesirable effects of unconscious conflicts by making the patient aware of their existence, origin, and inappropriate expression in current emotions and behavior. Balint Psychoanalytic Therapy,Psychoanalytic Therapy, Balint,Psychoanalytical Therapy,Therapy, Balint Psychoanalytic,Therapy, Psychoanalytic,Psychoanalytic Therapies,Psychoanalytical Therapies,Therapies, Psychoanalytic,Therapies, Psychoanalytical,Therapy, Psychoanalytical
D012050 Rehabilitation, Vocational Training of the mentally or physically disabled in work skills so they may be returned to regular employment utilizing these skills. Vocational Rehabilitation,Rehabilitations, Vocational,Vocational Rehabilitations
D003291 Conversion Disorder A disorder whose predominant feature is a loss or alteration in physical functioning that suggests a physical disorder but that is actually a direct expression of a psychological conflict or need. Astasia-Abasia,Conversion Neurosis,Functional Movement Disorder,Functional Neurological Disorder,Hysteria, Conversion,Conversion Reaction,Astasia Abasia,Conversion Disorders,Conversion Hysteria,Conversion Neuroses,Disorder, Functional Movement,Disorder, Functional Neurological,Functional Movement Disorders,Functional Neurological Disorders,Movement Disorder, Functional,Movement Disorders, Functional,Neurological Disorder, Functional,Neurological Disorders, Functional,Neuroses, Conversion,Neurosis, Conversion
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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