Hysterical paraplegia

J Neurol Neurosurg Psychiatry. 1987 Apr;50(4):375-82. doi: 10.1136/jnnp.50.4.375.


Between 1944 and 1984 20 patients were admitted to a spinal injuries centre with a diagnosis of traumatic paraplegia. They subsequently walked out and the diagnosis was revised to hysterical paraplegia. A further 23 patients with incomplete traumatic injuries, who also walked from the centre, have been compared with them as controls. The features that enabled a diagnosis of hysterical paraplegia to be arrived at were: They were predominantly paraplegic, There was a high incidence of previous psychiatric illness and employment in the Health Service or allied professions, Many were actively seeking compensation. The physical findings were a disproportionate motor paralysis, non anatomical sensory loss, the presence of downgoing plantar responses, normal tone and reflexes. They made a rapid total recovery. In contrast, the control traumatic cases showed an incomplete recovery and a persistent residual neurological deficit. Investigations apart from plain radiographs of the spinal column were not warranted, and the diagnosis should be possible on clinical grounds alone.

MeSH terms

  • Female
  • Humans
  • Hysteria / diagnosis*
  • Male
  • Medical History Taking
  • Paraplegia / psychology*
  • Physical Examination
  • Psychophysiologic Disorders / diagnosis*
  • Spinal Cord Injuries / diagnosis