Modification of both functional neurological symptoms and neuroimaging patterns with a good anatomoclinical concordance: a case report

Background In the nineteenth century, Jean Martin Charcot explained functional neurological disorder (formerly called conversion disorder) as a “psychodynamic” lesion. Numerous advances in neuroimaging have permitted identification of the neural underpinnings of this disorder. Case presentation Here...

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Vydané v:	BMC neurology Ročník 19; číslo 1; s. 270 - 14
Hlavní autori:	Galli, Silvio, Aybek, Selma, Chokron, Sylvie, Moulin, Thierry, Magnin, Eloi
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	London BioMed Central 04.11.2019 BioMed Central Ltd BMC
Predmet:	Brain Brain - diagnostic imaging Brain - physiopathology Case Report CAT scans Cognitive science Conversion disorder Conversion Disorder - diagnostic imaging Conversion Disorder - physiopathology Conversion disorders Dissociative disorders Functional neurological disorders Humans Medicine Medicine & Public Health Movement disorders Nervous system diseases Neurochemistry Neuroimaging Neurologic manifestations Neurology Neurosurgery Semantics Single photon emission computed tomography SPECT Tomography Tomography, Emission-Computed, Single-Photon Functional neurological disorders Dissociative disorders Conversion disorders SPECT
ISSN:	1471-2377, 1471-2377
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Abstract	Background In the nineteenth century, Jean Martin Charcot explained functional neurological disorder (formerly called conversion disorder) as a “psychodynamic” lesion. Numerous advances in neuroimaging have permitted identification of the neural underpinnings of this disorder. Case presentation Herein we describe a case of functional neurological disorder (FND) with initial left sensorimotor deficit, in-coordinated limb movements, neglect, clouded consciousness, slurred speech and a semiology of visual impairment. A single photon emission computed tomography (SPECT) showed a right thalamic hypoperfusion, which is rather concordant with the initial semiology. Later, the semiology changed, presenting with a predominantly neurovisual complex presentation. The second SPECT showed no more thalamic abnormalities but an hypoperfusion in the right temporo-occipital junction, right inferior parietal lobe and left superior frontal lobe, which is also rather concordant with the changing semiology. Conclusions This case illustrates the evolving neuroimaging patterns of FND but also the concordance between semiology and neuroimaging findings in FND supporting Charcot's theory of “dynamic lesion”.
AbstractList	In the nineteenth century, Jean Martin Charcot explained functional neurological disorder (formerly called conversion disorder) as a "psychodynamic" lesion. Numerous advances in neuroimaging have permitted identification of the neural underpinnings of this disorder.BACKGROUNDIn the nineteenth century, Jean Martin Charcot explained functional neurological disorder (formerly called conversion disorder) as a "psychodynamic" lesion. Numerous advances in neuroimaging have permitted identification of the neural underpinnings of this disorder.Herein we describe a case of functional neurological disorder (FND) with initial left sensorimotor deficit, in-coordinated limb movements, neglect, clouded consciousness, slurred speech and a semiology of visual impairment. A single photon emission computed tomography (SPECT) showed a right thalamic hypoperfusion, which is rather concordant with the initial semiology. Later, the semiology changed, presenting with a predominantly neurovisual complex presentation. The second SPECT showed no more thalamic abnormalities but an hypoperfusion in the right temporo-occipital junction, right inferior parietal lobe and left superior frontal lobe, which is also rather concordant with the changing semiology.CASE PRESENTATIONHerein we describe a case of functional neurological disorder (FND) with initial left sensorimotor deficit, in-coordinated limb movements, neglect, clouded consciousness, slurred speech and a semiology of visual impairment. A single photon emission computed tomography (SPECT) showed a right thalamic hypoperfusion, which is rather concordant with the initial semiology. Later, the semiology changed, presenting with a predominantly neurovisual complex presentation. The second SPECT showed no more thalamic abnormalities but an hypoperfusion in the right temporo-occipital junction, right inferior parietal lobe and left superior frontal lobe, which is also rather concordant with the changing semiology.This case illustrates the evolving neuroimaging patterns of FND but also the concordance between semiology and neuroimaging findings in FND supporting Charcot's theory of "dynamic lesion".CONCLUSIONSThis case illustrates the evolving neuroimaging patterns of FND but also the concordance between semiology and neuroimaging findings in FND supporting Charcot's theory of "dynamic lesion". This case illustrates the evolving proteiform neuroimaging patterns of FND but also the concordance between semiology and neuroimaging findings in FND. Background In the nineteenth century, Jean Martin Charcot explained functional neurological disorder (formerly called conversion disorder) as a "psychodynamic" lesion. Numerous advances in neuroimaging have permitted identification of the neural underpinnings of this disorder. Case presentation Herein we describe a case of functional neurological disorder (FND) with initial left sensorimotor deficit, in-coordinated limb movements, neglect, clouded consciousness, slurred speech and a semiology of visual impairment. A single photon emission computed tomography (SPECT) showed a right thalamic hypoperfusion, which is rather concordant with the initial semiology. Later, the semiology changed, presenting with a predominantly neurovisual complex presentation. The second SPECT showed no more thalamic abnormalities but an hypoperfusion in the right temporo-occipital junction, right inferior parietal lobe and left superior frontal lobe, which is also rather concordant with the changing semiology. Conclusions This case illustrates the evolving neuroimaging patterns of FND but also the concordance between semiology and neuroimaging findings in FND supporting Charcot's theory of "dynamic lesion". Keywords: Functional neurological disorders, Conversion disorders, Dissociative disorders, SPECT Abstract Background In the nineteenth century, Jean Martin Charcot explained functional neurological disorder (formerly called conversion disorder) as a “psychodynamic” lesion. Numerous advances in neuroimaging have permitted identification of the neural underpinnings of this disorder. Case presentation Herein we describe a case of functional neurological disorder (FND) with initial left sensorimotor deficit, in-coordinated limb movements, neglect, clouded consciousness, slurred speech and a semiology of visual impairment. A single photon emission computed tomography (SPECT) showed a right thalamic hypoperfusion, which is rather concordant with the initial semiology. Later, the semiology changed, presenting with a predominantly neurovisual complex presentation. The second SPECT showed no more thalamic abnormalities but an hypoperfusion in the right temporo-occipital junction, right inferior parietal lobe and left superior frontal lobe, which is also rather concordant with the changing semiology. Conclusions This case illustrates the evolving neuroimaging patterns of FND but also the concordance between semiology and neuroimaging findings in FND supporting Charcot's theory of “dynamic lesion”. In the nineteenth century, Jean Martin Charcot explained functional neurological disorder (formerly called conversion disorder) as a "psychodynamic" lesion. Numerous advances in neuroimaging have permitted identification of the neural underpinnings of this disorder. This case illustrates the evolving neuroimaging patterns of FND but also the concordance between semiology and neuroimaging findings in FND supporting Charcot's theory of "dynamic lesion". In the nineteenth century, Jean Martin Charcot explained functional neurological disorder (formerly called conversion disorder) as a "psychodynamic" lesion. Numerous advances in neuroimaging have permitted identification of the neural underpinnings of this disorder. Herein we describe a case of functional neurological disorder (FND) with initial left sensorimotor deficit, in-coordinated limb movements, neglect, clouded consciousness, slurred speech and a semiology of visual impairment. A single photon emission computed tomography (SPECT) showed a right thalamic hypoperfusion, which is rather concordant with the initial semiology. Later, the semiology changed, presenting with a predominantly neurovisual complex presentation. The second SPECT showed no more thalamic abnormalities but an hypoperfusion in the right temporo-occipital junction, right inferior parietal lobe and left superior frontal lobe, which is also rather concordant with the changing semiology. This case illustrates the evolving neuroimaging patterns of FND but also the concordance between semiology and neuroimaging findings in FND supporting Charcot's theory of "dynamic lesion". Background In the nineteenth century, Jean Martin Charcot explained functional neurological disorder (formerly called conversion disorder) as a “psychodynamic” lesion. Numerous advances in neuroimaging have permitted identification of the neural underpinnings of this disorder. Case presentation Herein we describe a case of functional neurological disorder (FND) with initial left sensorimotor deficit, in-coordinated limb movements, neglect, clouded consciousness, slurred speech and a semiology of visual impairment. A single photon emission computed tomography (SPECT) showed a right thalamic hypoperfusion, which is rather concordant with the initial semiology. Later, the semiology changed, presenting with a predominantly neurovisual complex presentation. The second SPECT showed no more thalamic abnormalities but an hypoperfusion in the right temporo-occipital junction, right inferior parietal lobe and left superior frontal lobe, which is also rather concordant with the changing semiology. Conclusions This case illustrates the evolving neuroimaging patterns of FND but also the concordance between semiology and neuroimaging findings in FND supporting Charcot's theory of “dynamic lesion”.
ArticleNumber	270
Audience	Academic
Author	Magnin, Eloi Moulin, Thierry Aybek, Selma Chokron, Sylvie Galli, Silvio
Author_xml	– sequence: 1 givenname: Silvio surname: Galli fullname: Galli, Silvio email: sgalli@chu-besancon.fr organization: Department of Neurology, University Hospital of Besançon – sequence: 2 givenname: Selma surname: Aybek fullname: Aybek, Selma organization: Neurology University Clinic, Inselspital – sequence: 3 givenname: Sylvie surname: Chokron fullname: Chokron, Sylvie organization: Laboratory of Psychology of Perception, UMR 8242, CNRS and Paris Descartes University and Vision and Cognition Unity, Fondation Ophtalmologique Rothschild – sequence: 4 givenname: Thierry surname: Moulin fullname: Moulin, Thierry organization: Department of Neurology, University Hospital of Besançon – sequence: 5 givenname: Eloi surname: Magnin fullname: Magnin, Eloi organization: Department of Neurology, University Hospital of Besançon
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Keywords	Functional neurological disorders Dissociative disorders Conversion disorders SPECT
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Snippet	Background In the nineteenth century, Jean Martin Charcot explained functional neurological disorder (formerly called conversion disorder) as a “psychodynamic”... In the nineteenth century, Jean Martin Charcot explained functional neurological disorder (formerly called conversion disorder) as a "psychodynamic" lesion.... Background In the nineteenth century, Jean Martin Charcot explained functional neurological disorder (formerly called conversion disorder) as a "psychodynamic"... This case illustrates the evolving proteiform neuroimaging patterns of FND but also the concordance between semiology and neuroimaging findings in FND. Abstract Background In the nineteenth century, Jean Martin Charcot explained functional neurological disorder (formerly called conversion disorder) as a...
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SubjectTerms	Brain Brain - diagnostic imaging Brain - physiopathology Case Report CAT scans Cognitive science Conversion disorder Conversion Disorder - diagnostic imaging Conversion Disorder - physiopathology Conversion disorders Dissociative disorders Functional neurological disorders Humans Medicine Medicine & Public Health Movement disorders Nervous system diseases Neurochemistry Neuroimaging Neurologic manifestations Neurology Neurosurgery Semantics Single photon emission computed tomography SPECT Tomography Tomography, Emission-Computed, Single-Photon
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Title	Modification of both functional neurological symptoms and neuroimaging patterns with a good anatomoclinical concordance: a case report
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Volume	19
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