article:http://discovermagazine.com/2007/nov/vital-signs/article_view?b_start:int=0&-C=summary:In his article "Instant Paralysis with an Instant Cure" (Nov. 2007 Discover) Frank
Vertosick, chief of neurosurgery for a city hospital, tells of his experience with a patient he calls Rachel. Rachel, 22 years old, had been admitted to the ER because she had woken up to discover she couldn't move her legs. Nothing hurt, she could feel touch, she had good muscle tone, and her reflexes were normal. Her medical history and that of her family revealed nothing. On top of that, she didn't seem concerned that she instantly become a paraplegic. "I really feel fine," she said with a shrug, "except for this leg thing." An MRI of her entire spine was being set up, but
Vertosick didn't see the point in taking thousands of dollars of photos: "The tests would all be negative anyway." Rachel had hysteria or "conversion disorder".
The word hysteria has a Greek origin related
to the word for womb. This makes some sense in that women patients outnumber men six to one. Like migraine and multiple sclerosis, the reason for the disproportion is unknown, but has nothing to do with the womb. Sigmund Freud believed that hysteria occurred when the mind changed some "psychic trauma into a physical malady that will both trigger sympathy and allow the sufferer to hide from her problems behind a shield of illness." Jean-Martin
Charcot disagreed, saying there actually was an organic brain illness, an idea which is supported by recent evidence. PET scans and
MRIs seem to indicate that hysteria is like a seizure initiated by the frontal lobes.
Apathy to one's condition, while a characteristic of hysteria, can also be caused by other illnesses. In conjunction with Rachel's other symptoms, however, it was "icing on the diagnostic cake." Once diagnosed, treating hysteria is rather simple. The patient truly believes they cannot move, so they must be convinced that they are receiving real medicine. For Rachel, being given an impressive-looking vitamin solution through an IV did the trick.
response:Vertosick makes an important distinction in his article between the brain and the mind. Hysteria is such a fascinating illness because it has hints of both. Concerning the brain, the latest pictures show the seizures of the frontal lobe. The research agrees with
Charcot. But Freud certainly wouldn't object to the requirements in treatment. Telling the hysteric that they are imagining paralysis won't cure it. But giving them a convincing placebo will.
I wonder how a patient who knew they were hysteric, and what hysteria was, would be treated. Or if you could control when they would recover by saying, 'if you take these pills, you should recover in a week' (or whatever time you chose.) In
addition, many patients tell stories of mental stress.
There are many questions remaining. Why are most hysterics women? What exactly is going on in the frontal lobes that makes the patient not move and not care that they can't move? How do stresses and genetics affect the onset of hysteria? What is the relationship between the mind and the brain?