Page 99 - JCBP-3-1

Journal of Clinical and
Basic Psychosomatics Functional neurological movement disorders

reappeared. Examinations revealed no somatic disorder. was fully awake and able to converse in her native language
An attempt was made to rehabilitate her, including exercise as well as Danish. She had severe left-side hemiparesis,
in a warm water swimming pool, but the symptoms normal tendon reflexes, and normal plantar reflexes. She
deteriorated. Subsequently, she was referred to a clinical was able to stand with support but with an abnormal
psychologist for a few consultations, but no improvement gait. We found a positive Hoover’s sign. All paraclinical
was seen. She walked with a walker. examinations were normal, including repeated brain MRI
In January 2013, she was referred to our Neurological and motor evoked potentials. We concluded that she was
Functional Team, State University Hospital (NFTSUH). suffering from functional hemiparesis, and she started
The neurological examination in a supine position and rehabilitation in our functional team.
tests for coordination showed normal results, but as soon One week after the rehabilitation had started, she was
as she tried to walk, she was extremely unsteady in a very able to transfer from the wheelchair to bed and toilet.
acrobatic and non-somatic manner. A walker, however, After another week, she was ambulatory and able to walk
stabilized her gait, allowing her to walk short distances. to the water basin by herself. This was the time point
Performing daily rehabilitation in a warm water swimming during the treatment course in which she expressed
pool and using a walker, combined with psychotherapy anger for unknown reasons at the fourth session with her
with our psychologist (H.-H.O.) twice a week, had led psychologist. After 1 week, she walked with a high walker.
to improvements, and after 2 – 3 weeks, she was able to Four weeks after the referral, she was able to climb the
walk short distances without support. At this time, she stairs a little. After another week, she walked with a walker
mentioned for the first time her sorrow related to her and revealed her secret of being violently assaulted in her
father’s abnormal reactions following the death of his wife. youth. In the following week, she was able to walk without
Within another week, her gait had normalized. Two weeks any kind of support, yet with a discrete weakness of the
later, the gait was stabilized further, and she was able to run left leg. The combined physio- and psycho-therapy lasted
and jump; she was discharged after 38 days of treatment. 6 weeks, and she was discharged to her home for further
We saw her 3 months after discharge at a planned physiotherapy at a local clinic.
follow-up. She was readmitted with symptoms similar to the 3.3. Patient 3
first admission. After undergoing a few new rehabilitation
sessions (physiotherapy and psychotherapy), her condition For this patient, an important part of the family history
normalized within 3 weeks. was that her mother suffered from multiple sclerosis and
died from this in July 2011 when the patient was 13 years
3.2. Patient 2 of age. According to the patient, her mother was a disabled
Patient 2 grew up as the third child and the only girl among person who needed help in almost all matters. The patient,
five siblings. Both parents used to consume alcohol heavily, as a child and adolescent, had suffered from guilt feelings
1 – 2 times each month. While young, she and her siblings for not being able to save her mother. Moreover, she was
stayed with their grandmother until their parents became often told that she had a close physical resemblance to her
sober. She performed well in school. She was a leisure- mother. Owing to the death of her mother, the patient had
time educator and later became a leader in a leisure-time a short series of consultations with a school psychologist.
institution. In her daily life, she has always been very active and
interested in sports.
She fell in November 2012 on an icy road and hit
her head, when she was 40 years old. She immediately In November 2015, she fell on her neck and back during
developed pain in the neck and dizziness and sought sports and immediately experienced pain in her neck,
medical attention the following day. Five days after the and she was admitted to a local hospital. MRI scan of the
fall she had nausea. Despite this, she continued working spines was normal and she was discharged once achieved
without taking leaves of any sort. Ten days after the fall, improvement. However, a few days following discharge,
she observed paraesthesia in the left part of her face and she developed paresis of both legs and complained of
reduced strength in the left-side extremities. Following paraesthesia from the feet to the hips. She could not walk.
the deterioration of the symptoms, she was admitted to a There were no problems with the urinary sphincter. She
local hospital. Finally, she became wheelchair-dependent was readmitted to hospital. A repeated MRI of the spines
due to severe left-side hemiparesis. A magnetic resonance showed normal findings.
imaging (MRI) scan of her brain was normal. She had a series of physiotherapy in different
She was referred to NFTSUH 2 months after the fall. departments in local hospitals. She improved a little but
At the time of the clinical neurological examination, she could still only walk with two sticks, and her legs trembled

Volume 3 Issue 1 (2025) 93 doi: 10.36922/jcbp.4369