Mental Breakdown with Deficits

[Happiness]

Since I was not the medic that did this call I wont do it as a senerio. Once Im done giving the information My question all of you is if you have ever heard of a Mental Breakdown that has stroke like deficits.

40 yr old female

Went for a nap and husband went to check on her, she was having a seizure that lasted about 3 mins. Ambulance called and transfered to hospital.

Pt stayed for observation. During the night she was confused and had 2 more seizures that lasted the same amount of time. After the second one the nero testing showed left sided weakness, weak grips, unable to stand, facial droop and when she stuck out her toung went right. She was feverish 37 and rosey in color. She was warm to touch. She was very emotional also.

We picked up CCT and brought them in. While there and after good doses of Dilantin, adivan and gravol she had 2 more seizures. The one medic said this could be a tumor and he has seen this before. So off she went to the city and the CT Scan showed nothing so they did a MRI the next day and again nothing. I should also mention this had happen before years ago but was only one seizure, no deficits and nothing found.

The Pt came back and I happen to be in the city and saw her at the airport. Now my medic eye noticed that she was still very emotional and was dragging her left leg a bit with a limp. She was holding a cup with her left hand and dropped it. One of her friends saw me later and said it was diagnosed as a Mental breakdown.

I am not a Dr. by any means but I have never heard of a Mental Breakdown that creates and retaines the stroke like deficits. Has anyone here?

Thanks Happy

[scubanurse]

I've never seen anything this severe, but I suppose it could be possible... I'm really curious to see what others have to say about this, thanks for sharing this case though!

[ERDoc]

Sounds like Conversion disorder. Another thought is Todd's Paralysis but this usually resolves within 48 hours.

[paramedicmike]

I thought conversion disorder, too, as one possibility. Mental health breakdowns/conditions can be wide ranging in their presentations. The brain is a funny thing and there's no telling how certain events/conditions will affect people.

I'm curious why they didn't do a head CT earlier. Of course, nobody can really answer that. It's just a random question I thought as I read the case.

[Happiness]

I thought conversion disorder, too, as one possibility. Mental health breakdowns/conditions can be wide ranging in their presentations. The brain is a funny thing and there's no telling how certain events/conditions will affect people.

I'm curious why they didn't do a head CT earlier. Of course, nobody can really answer that. It's just a random question I thought as I read the case.

I live on a pacific island that has no CT Scan, so we get to medivac them out for one and in her case it took about 48 hrs to get her out.

[paramedicmike]

That's a good reason.