Objective

Patients with conversion paralyses have the same disabilities and handicaps as patients with organic paralyses. We report 4 cases of patients with conversion paralyses who have been managed in our physical medicine and rehabilitation department during twelve months.

Observations

Two women and 2 men ages 33, 19, 18 and 41 years presented conversion paralyses. The paralyses were varied: hemiplegia, paraplegia, paralysis of the upper limb and paralysis of the lower limb. Three patients consulted before the 6th month and one patient consulted after the 6th month (paraplegia).

All patients showed disabilities and restriction of their autonomy. Their Functional Independence Measure (FIM) were: 90, 85, 107, 90. Two patients had an occupational disability. Psychiatric assessment revealed anxiety in all patients and hysterical personality and depression in three patients. All patients have been treated in physical medicine and rehabilitation, psychiatry and psychotherapy. Three patients recovered completely. Their FIM is 126. The patient with paraplegia can walk with an assistive device. Her FIM is 117. Anxiety persisted in all patients and depressive symptoms have improved among patients concerned. Both patients resumed their professional activity.

Discussion–conclusion

Our patients had functional and professional disabilities and their autonomy was limited as if their paralyses were organic. Psychiatric comorbidities were associated as: anxiety, depression and histrionic personality. The physical medicine and rehabilitation management combined with a treatment in psychiatry and psychotherapy permitted the full recovery of autonomy in three patients and the partial recovery of autonomy in the patient with paraplegia. Anxiety symptoms persisted and depressive symptoms improved in patients. Multidisciplinary approach involving physical medicine and rehabilitation, psychiatry and psychotherapy has improved the autonomy and depression among our patients. Patients who have had an early treatment had the best results.