Factitious quadriplegia. A rare new case and literature review

Triparesis: an unusual presentation of factitious disorder

Factitious disorder (FD) has diverse presentations but neurological presentation is unusual. In this report, we discuss a case of FD who presented with triparesis, that is, weakness of both lower limbs and right upper limb. Diagnosis of FD was made after detailed clinical evaluation, review of past medical records that revealed extensive evaluation to rule out physical illness, and inability to find any associated stressful event or material gain associated with illness. Management was largely supportive and was based on psychotherapy. Identification of FD depends on a high index of suspicion by the physician and the presence of atypical and medically unexplainable signs/symptoms.

A case of factitious disorder involving menstrual blood smeared on the face

This article presents a case of factitious disorder in which a female smeared menstrual blood on her face. The patient was admitted to our otolaryngology clinic complaining of bleeding from the mouth, nose, ears and eyes. This event reportedly occurred three to four times on a daily basis. She acknowledged nine prior admissions to different specialists over the last two years. Following psychiatric consultation, we diagnosed factitious disorder with predominantly physical signs and symptoms. She was started on Fluoxetine 20 mg/day and supportive interviews were organized. After diagnosis, we observed that her symptoms decreased over two months. The symptoms did not reoccur three to nine months after treatment. This case report outlines two important features. The first is that a case of this type has not been reported before, and the second feature is that this case demonstrates the effect of cultural factors greatly different from those seen in classical factitious disorder.

Munchausen syndrome in obstetrics and gynecology

Munchausen syndrome (MS) is a well-defined clinical psychiatric entity. Furthermore, it is a complicated and intriguing problem in medicine in general and in obstetrics and gynecology in particular. The proportion of MS cases in obstetrics and gynecology is rising. This review covers relevant reports from the last four decades. Emphasis is put on the clinical expression of MS cases in obstetrics and gynecology. A discussion about their validity as such is included. Awareness of attending physicians to this type of illness in the era of patient rights, on the one hand, and the existence of defensive medicine on the other, is crucial.

Medicolegal complications of pseudologia fantastica

A 46-year-old woman allegedly on a witness protection scheme who died under unusual circumstances with a factitious history of two previous homicide attempts and multiple medical problems including paraplegia and lung carcinoma is presented to demonstrate difficulties that may arise in the medicolegal investigation of such cases. A diagnosis of pseudologia fantastica was made once no corroboration of the presenting history or medical illnesses could be made. Death was due to haemorrhage from a self-inflicted incised wound to the arm.

Factitious deafblindness: an imperceptible variant of factitious disorder

We describe two women who, over a period of years, feigned the loss of both vision and hearing. Their principal motive appeared to be pursuit of the sick role, though each acquired disability payments as well. A face-saving intervention sharply reduced the alleged hearing deficits in one case; the other patient precipitously left treatment. A broad range of permutations of factitious disorder has been reported, but these appear to be the first published cases of factitious deafblindness.