Psychogenic paralysis and recovery after motor cortex transcranial magnetic stimulation
Identifieur interne : 001420 ( Istex/Corpus ); précédent : 001419; suivant : 001421Psychogenic paralysis and recovery after motor cortex transcranial magnetic stimulation
Auteurs : Nathalie Chastan ; Dominique ParainSource :
- Movement Disorders [ 0885-3185 ] ; 2010-07-30.
English descriptors
Abstract
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. © 2010 Movement Disorder Society
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DOI: 10.1002/mds.23187
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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. © 2010 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Nathalie Chastan MD, PhD</name><affiliations><json:string>Department of Neurophysiology, Rouen University Hospital, Rouen, France</json:string><json:string>CHU de Rouen—Hôpital Charles Nicolle, Service de Neurophysiologie, 1 rue de Germont, 76031 Rouen Cedex, France</json:string></affiliations></json:item><json:item><name>Dominique Parain MD, PhD</name><affiliations><json:string>Department of Neurophysiology, Rouen University Hospital, Rouen, France</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>conversion disorder</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>motor paralysis</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>transcranial magnetic stimulation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>motor cortex</value></json:item></subject><articleId><json:string>MDS23187</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>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. 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Scand</title></host><title>Psychogenic disorders in neurology: frequency and clinical spectrum</title></json:item><json:item><author><json:item><name>W Couprie</name></json:item><json:item><name>EF Wijdicks</name></json:item><json:item><name>HG Rooijmans</name></json:item><json:item><name>J van Gijn</name></json:item></author><host><volume>58</volume><pages><last>752</last><first>750</first></pages><author></author><title>J Neurol Neurosurg Psychiatry</title></host><title>Outcome in conversion disorder: a follow up study</title></json:item><json:item><author><json:item><name>HL Crimlisk</name></json:item><json:item><name>K Bhatia</name></json:item><json:item><name>H Cope</name></json:item><json:item><name>A David</name></json:item><json:item><name>CD Marsden</name></json:item><json:item><name>MA Ron</name></json:item></author><host><volume>316</volume><pages><last>586</last><first>582</first></pages><author></author><title>BMJ</title></host><title>Slater revisited: 6 year follow up study of patients with medically unexplained motor symptoms</title></json:item><json:item><author><json:item><name>RJ Heruti</name></json:item><json:item><name>J Reznik</name></json:item><json:item><name>A Adunski</name></json:item><json:item><name>A Levy</name></json:item><json:item><name>H Weingarden</name></json:item><json:item><name>A Ohry</name></json:item></author><host><volume>40</volume><pages><last>340</last><first>335</first></pages><author></author><title>Spinal Cord</title></host><title>Conversion motor paralysis disorder: analysis of 34 consecutive referrals</title></json:item><json:item><author><json:item><name>EJ Letonoff</name></json:item><json:item><name>TR Williams</name></json:item><json:item><name>KS Sidhu</name></json:item></author><host><volume>27</volume><pages><last>445</last><first>441</first></pages><author></author><title>Spine</title></host><title>Hysterical paralysis: a report of three cases and a review of the literature</title></json:item><json:item><author><json:item><name>J Stone</name></json:item><json:item><name>M Sharpe</name></json:item><json:item><name>PM Rothwell</name></json:item><json:item><name>CP Warlow</name></json:item></author><host><volume>74</volume><pages><last>596</last><first>591</first></pages><author></author><title>J Neurol Neurosurg Psychiatry</title></host><title>The 12 year prognosis of unilateral functional weakness and sensory disturbance</title></json:item><json:item><author><json:item><name>M Burgmer</name></json:item><json:item><name>C Konrad</name></json:item><json:item><name>A Jansen</name></json:item></author><host><volume>29</volume><pages><last>1343</last><first>1336</first></pages><author></author><title>Neuroimage</title></host><title>Abnormal brain activation during movement observation in patients with conversion paralysis</title></json:item><json:item><author><json:item><name>R Cantello</name></json:item><json:item><name>C Boccagni</name></json:item><json:item><name>C Comi</name></json:item><json:item><name>C Civardi</name></json:item><json:item><name>F Monaco</name></json:item></author><host><volume>248</volume><pages><last>897</last><first>889</first></pages><author></author><title>J Neurol</title></host><title>Diagnosis of psychogenic paralysis: the role of motor evoked potentials</title></json:item><json:item><author><json:item><name>J Foong</name></json:item><json:item><name>M Ridding</name></json:item><json:item><name>H Cope</name></json:item><json:item><name>CD Marsden</name></json:item><json:item><name>MA Ron</name></json:item></author><host><volume>9</volume><pages><last>303</last><first>302</first></pages><author></author><title>J Neuropsychiatry Clin Neurosci</title></host><title>Corticospinal function in conversion disorder</title></json:item><json:item><author><json:item><name>JJ Pillai</name></json:item><json:item><name>S Markind</name></json:item><json:item><name>LJ Streletz</name></json:item><json:item><name>HL Field</name></json:item><json:item><name>G Herbison</name></json:item></author><host><volume>42</volume><pages><last>936</last><first>935</first></pages><author></author><title>Neurology</title></host><title>Motor evoked potentials in psychogenic paralysis</title></json:item><json:item><author><json:item><name>M Binzer</name></json:item><json:item><name>PM Andersen</name></json:item><json:item><name>G Kullgren</name></json:item></author><host><volume>63</volume><pages><last>88</last><first>83</first></pages><author></author><title>J Neurol Neurosurg Psychiatry</title></host><title>Clinical characteristics of patients with motor disability due to conversion disorder: a prospective control group study</title></json:item><json:item><author><json:item><name>M Binzer</name></json:item><json:item><name>G Kullgren</name></json:item></author><host><volume>39</volume><pages><last>527</last><first>519</first></pages><author></author><title>Psychosomatics</title></host><title>Motor conversion disorder. A prospective 2‐ to 5‐year follow‐up study</title></json:item><json:item><author><json:item><name>P Schwingenschuh</name></json:item><json:item><name>C Pont‐Sunyer</name></json:item><json:item><name>R Surtees</name></json:item><json:item><name>MJ Edwards</name></json:item><json:item><name>KP Bhatia</name></json:item></author><host><volume>23</volume><pages><last>1888</last><first>1882</first></pages><author></author><title>Mov Disord</title></host><title>Psychogenic movement disorders in children: a report of 15 cases and a review of the literature</title></json:item><json:item><author><json:item><name>J Stone</name></json:item><json:item><name>A Carson</name></json:item><json:item><name>H Aditya</name></json:item></author><host><volume>66</volume><pages><last>390</last><first>383</first></pages><author></author><title>J Psychosom Res</title></host><title>The role of physical injury in motor and sensory conversion symptoms: a systematic and narrative review</title></json:item><json:item><author><json:item><name>K Kroenke</name></json:item><json:item><name>R Swindle</name></json:item></author><host><volume>69</volume><pages><last>215</last><first>205</first></pages><author></author><title>Psychother Psychosom</title></host><title>Cognitive‐behavioral therapy for somatization and symptom syndromes: a critical review of controlled clinical trials</title></json:item><json:item><author><json:item><name>PG O'Malley</name></json:item><json:item><name>JL Jackson</name></json:item><json:item><name>J Santoro</name></json:item><json:item><name>G Tomkins</name></json:item><json:item><name>E Balden</name></json:item><json:item><name>K Kroenke</name></json:item></author><host><volume>48</volume><pages><last>990</last><first>980</first></pages><author></author><title>J Fam Pract</title></host><title>Antidepressant therapy for unexplained symptoms and symptom syndromes</title></json:item><json:item><author><json:item><name>FC Moene</name></json:item><json:item><name>P Spinhoven</name></json:item><json:item><name>KA Hoogduin</name></json:item><json:item><name>R van Dyck</name></json:item></author><host><volume>71</volume><pages><last>76</last><first>66</first></pages><author></author><title>Psychother Psychosom</title></host><title>A randomised controlled clinical trial on the additional effect of hypnosis in a comprehensive treatment programme for in‐patients with conversion disorder of the motor type</title></json:item><json:item><author><json:item><name>FC Moene</name></json:item><json:item><name>P Spinhoven</name></json:item><json:item><name>KA Hoogduin</name></json:item><json:item><name>R van Dyck</name></json:item></author><host><volume>51</volume><pages><last>50</last><first>29</first></pages><author></author><title>Int J Clin Exp Hypn</title></host><title>A randomized controlled clinical trial of a hypnosis‐based treatment for patients with conversion disorder, motor type</title></json:item><json:item><author><json:item><name>ZY Zhang</name></json:item><json:item><name>YM Yuan</name></json:item><json:item><name>BW Yan</name></json:item><json:item><name>YQ Tian</name></json:item><json:item><name>W Wang</name></json:item><json:item><name>LM Fan</name></json:item></author><host><volume>7</volume><pages><last>115</last><first>113</first></pages><author></author><title>J Tradit Chin Med</title></host><title>An observation of 1316 cases of hysterical paralysis treated by acupuncture</title></json:item><json:item><author><json:item><name>DA Jellinek</name></json:item><json:item><name>R Bradford</name></json:item><json:item><name>I Bailey</name></json:item><json:item><name>L Symon</name></json:item></author><host><volume>30</volume><pages><last>302</last><first>300</first></pages><author></author><title>Paraplegia</title></host><title>The role of motor evoked potentials in the management of hysterical paraplegia: case report</title></json:item><json:item><author><json:item><name>N Chastan</name></json:item><json:item><name>D Parain</name></json:item><json:item><name>E Verin</name></json:item><json:item><name>J Weber</name></json:item><json:item><name>MA Faure</name></json:item><json:item><name>JP Marie</name></json:item></author><host><volume>80</volume><pages><first>94</first></pages><author></author><title>J Neurol Neurosurg Psychiatry</title></host><title>Psychogenic aphonia: spectacular recovery after motor cortex transcranial magnetic stimulation</title></json:item><json:item><author><json:item><name>C Schonfeldt‐Lecuona</name></json:item><json:item><name>BJ Connemann</name></json:item><json:item><name>R Viviani</name></json:item><json:item><name>M Spitzer</name></json:item><json:item><name>U Herwig</name></json:item></author><host><volume>23</volume><pages><last>475</last><first>472</first></pages><author></author><title>J Clin Neurophysiol</title></host><title>Transcranial magnetic stimulation in motor conversion disorder: a short case series</title></json:item><json:item><author><json:item><name>JC Marshall</name></json:item><json:item><name>PW Halligan</name></json:item><json:item><name>GR Fink</name></json:item><json:item><name>DT Wade</name></json:item><json:item><name>RS Frackowiak</name></json:item></author><host><volume>64</volume><pages><last>8</last><first>1</first></pages><author></author><title>Cognition</title></host><title>The functional anatomy of a hysterical paralysis</title></json:item><json:item><author><json:item><name>R Geraldes</name></json:item><json:item><name>M Coelho</name></json:item><json:item><name>MM Rosa</name></json:item><json:item><name>L Severino</name></json:item><json:item><name>J Castro</name></json:item><json:item><name>M de Carvalho</name></json:item></author><host><volume>79</volume><pages><last>1413</last><first>1412</first></pages><author></author><title>J Neurol Neurosurg Psychiatry</title></host><title>Abnormal transcranial magnetic stimulation in a patient with presumed psychogenic paralysis</title></json:item><json:item><author><json:item><name>TA Hurwitz</name></json:item><json:item><name>JW Prichard</name></json:item></author><host><volume>67</volume><pages><last>1915</last><first>1914</first></pages><author></author><title>Neurology</title></host><title>Conversion disorder and fMRI</title></json:item></refBibs><genre><json:string>article</json:string></genre><host><volume>25</volume><publisherId><json:string>MDS</json:string></publisherId><pages><total>4</total><last>1504</last><first>1501</first></pages><issn><json:string>0885-3185</json:string></issn><issue>10</issue><subject><json:item><value>Brief Report</value></json:item></subject><genre><json:string>journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1531-8257</json:string></eissn><title>Movement 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stimulation</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>Copyright © 2010 Movement Disorder Society</p></availability><date>2010</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Psychogenic paralysis and recovery after motor cortex transcranial magnetic stimulation</title><author xml:id="author-1"><persName><forename type="first">Nathalie</forename><surname>Chastan</surname></persName><roleName type="degree">MD, PhD</roleName><note type="biography">Potential conflict of interest: The authors confirm that there was no conflict of interest. The authors have no financial disclosures or additional information to disclose.</note><affiliation>Potential conflict of interest: The authors confirm that there was no conflict of interest. The authors have no financial disclosures or additional information to disclose.</affiliation><affiliation>Department of Neurophysiology, Rouen University Hospital, Rouen, France</affiliation><affiliation>CHU de Rouen—Hôpital Charles Nicolle, Service de Neurophysiologie, 1 rue de Germont, 76031 Rouen Cedex, France</affiliation></author><author xml:id="author-2"><persName><forename type="first">Dominique</forename><surname>Parain</surname></persName><roleName type="degree">MD, PhD</roleName><note type="biography">Potential conflict of interest: The authors confirm that there was no conflict of interest. The authors have no financial disclosures or additional information to disclose.</note><affiliation>Potential conflict of interest: The authors confirm that there was no conflict of interest. The authors have no financial disclosures or additional information to disclose.</affiliation><affiliation>Department of Neurophysiology, Rouen University Hospital, Rouen, France</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2010-07-30"></date><biblScope unit="volume">25</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1501">1501</biblScope><biblScope unit="page" to="1504">1504</biblScope></imprint></monogr><idno type="istex">9EE3CC141E564E1D32D480B88A8DA877FA79A82A</idno><idno type="DOI">10.1002/mds.23187</idno><idno type="ArticleID">MDS23187</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>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. © 2010 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>keywords</head><item><term>conversion disorder</term></item><item><term>motor paralysis</term></item><item><term>transcranial magnetic stimulation</term></item><item><term>motor cortex</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article-category</head><item><term>Brief Report</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2009-11-11">Received</change><change when="2010-03-23">Registration</change><change when="2010-07-30">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/9EE3CC141E564E1D32D480B88A8DA877FA79A82A/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="100"><doi origin="wiley" registered="yes">10.1002/mds.v25:10</doi><numberingGroup><numbering type="journalVolume" number="25">25</numbering><numbering type="journalIssue">10</numbering></numberingGroup><coverDate startDate="2010-07-30">30 July 2010</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="270" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.23187</doi><idGroup><id type="unit" value="MDS23187"></id></idGroup><countGroup><count type="pageTotal" number="4"></count></countGroup><titleGroup><title type="articleCategory">Brief Report</title><title type="tocHeading1">Brief Reports</title></titleGroup><copyright ownership="thirdParty">Copyright © 2010 Movement Disorder Society</copyright><eventGroup><event type="manuscriptReceived" date="2009-11-11"></event><event type="manuscriptRevised" date="2010-01-28"></event><event type="manuscriptAccepted" date="2010-03-23"></event><event type="firstOnline" date="2010-06-21"></event><event type="publishedOnlineFinalForm" date="2010-07-23"></event><event type="publishedOnlineAcceptedOrEarlyUnpaginated" date="2010-06-21"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.5.2 mode:FullText source:FullText result:FullText" date="2011-06-21"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-31"></event></eventGroup><numberingGroup><numbering type="pageFirst">1501</numbering><numbering type="pageLast">1504</numbering></numberingGroup><correspondenceTo>CHU de Rouen—Hôpital Charles Nicolle, Service de Neurophysiologie, 1 rue de Germont, 76031 Rouen Cedex, France</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS23187.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="2"></count><count type="tableTotal" number="0"></count><count type="referenceTotal" number="25"></count><count type="wordTotal" number="2441"></count></countGroup><titleGroup><title type="main" xml:lang="en">Psychogenic paralysis and recovery after motor cortex transcranial magnetic stimulation</title><title type="short" xml:lang="en">Psychogenic Paralysis and rTMS</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes" noteRef="#fn1"><personName><givenNames>Nathalie</givenNames><familyName>Chastan</familyName><degrees>MD, PhD</degrees></personName><contactDetails><email normalForm="nathalie.chastan@chu-rouen.fr">nathalie.chastan@chu‐rouen.fr</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1" noteRef="#fn1"><personName><givenNames>Dominique</givenNames><familyName>Parain</familyName><degrees>MD, PhD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="FR" type="organization"><unparsedAffiliation>Department of Neurophysiology, Rouen University Hospital, Rouen, France</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">conversion disorder</keyword><keyword xml:id="kwd2">motor paralysis</keyword><keyword xml:id="kwd3">transcranial magnetic stimulation</keyword><keyword xml:id="kwd4">motor cortex</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>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. © 2010 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>Potential conflict of interest: The authors confirm that there was no conflict of interest. The authors have no financial disclosures or additional information to disclose.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Psychogenic paralysis and recovery after motor cortex transcranial magnetic stimulation</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Psychogenic Paralysis and rTMS</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Psychogenic paralysis and recovery after motor cortex transcranial magnetic stimulation</title></titleInfo><name type="personal"><namePart type="given">Nathalie</namePart><namePart type="family">Chastan</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurophysiology, Rouen University Hospital, Rouen, France</affiliation><description>Potential conflict of interest: The authors confirm that there was no conflict of interest. The authors have no financial disclosures or additional information to disclose.</description><affiliation>CHU de Rouen—Hôpital Charles Nicolle, Service de Neurophysiologie, 1 rue de Germont, 76031 Rouen Cedex, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Dominique</namePart><namePart type="family">Parain</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurophysiology, Rouen University Hospital, Rouen, France</affiliation><description>Potential conflict of interest: The authors confirm that there was no conflict of interest. The authors have no financial disclosures or additional information to disclose.</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2010-07-30</dateIssued><dateCaptured encoding="w3cdtf">2009-11-11</dateCaptured><dateValid encoding="w3cdtf">2010-03-23</dateValid><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">2</extent><extent unit="references">25</extent><extent unit="words">2441</extent></physicalDescription><abstract lang="en">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. © 2010 Movement Disorder Society</abstract><subject lang="en"><genre>keywords</genre><topic>conversion disorder</topic><topic>motor paralysis</topic><topic>transcranial magnetic stimulation</topic><topic>motor cortex</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. 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