Psychogenic paralysis and recovery after motor cortex transcranial magnetic stimulation

Mov Disord. 2010 Jul 30;25(10):1501-4. doi: 10.1002/mds.23187.


Psychogenic paralysis presents a real treatment challenge. Despite psychotherapy, physiotherapy, antidepressants, acupuncture, or hypnosis, the outcome is not always satisfactory with persistent symptoms after long-term follow-up. We conducted a retrospective study to assess clinical features and to propose an alternative treatment based on repetitive transcranial magnetic stimulation (rTMS). Seventy patients (44 F/26 M, mean age: 24.7 +/- 16.6 years) experienced paraparesis (57%), monoparesis (37%), tetraparesis (3%), or hemiparesis (3%). A precipitating event was observed in 42 patients, primarily as a psychosocial event or a physical injury. An average of 30 stimuli over the motor cortex contralateral to the corresponding paralysis was delivered at low frequency with a circular coil. The rTMS was effective in 89% of cases, with a significantly better outcome for acute rather than chronic symptoms. In conclusion, motor cortex rTMS seem to be very effective in patients with psychogenic paralysis and could be considered a useful therapeutic option.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motor Cortex / physiology*
  • Paralysis* / pathology
  • Paralysis* / psychology
  • Paralysis* / therapy
  • Recovery of Function / physiology*
  • Retrospective Studies
  • Transcranial Magnetic Stimulation / methods*
  • Young Adult