Chasing the Chameleon Psychogenic Paraparesis Responding to Non-Invasive Brain Stimulation

Simona Portaro, Demetrio Milardi, Antonino Naro, Antonio Chillura, Francesco Corallo, Angelo Quartarone, Rocco Salvatore Calabrò

Research output: Contribution to journalArticlepeer-review


Neurologic symptoms that develop unconsciously and are incompatible with known pathophysiologic mechanisms or anatomic pathways belong to Conversion Disorder (CD). CD diagnosis is based on the clinical history and the exclusion of physical disorders causing significant distress or social and occupational impairment. In a subgroup of CD, called functional weakness (FW), symptoms affecting limbs may be persistent, thus causing a permanent or transient loss of limb function. Physiotherapy, pharmacotherapy, hypnotherapy and repetitive transcranial magnetic stimulation (rTMS) have been proposed as treatment strategies for FW-CD. Herein, we report a 30 year-old male, presenting with lower limb functional paraparesis, having obtained positive, objectively, and stable effects from a prolonged r-TMS protocol associated to a multidisciplinary approach, including psychological and sexuological counseling, and monitored by gait analysis. We postulate that our rTMS protocol, combined with a multidisciplinary approach may be the proper treatment strategy to improve FW-CD.

Original languageEnglish
Pages (from-to)428-431
Number of pages4
JournalPsychiatry Investigation
Issue number4
Publication statusPublished - Apr 2018


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