ヒステリー転換症状による開眼失行の1症例

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Apraxia of lid opening is an insufficiency of initiaating lid opening that was termed by Schilder in 1927 and has been described as supranuclear abnormalities (i.e. the levator neurons are inhibited). This disorder is tended to be easily confused with blepharospasm or blepharoptosis. Though the latter two diseases are thought to be caused by a conversion mechanism, it has not been reported that apraxia of lid opening is owing to that mechanism. The following case, to our knowledge, is the first report of a patient suffering from apraxia of lid opening as a conversion symptom. Case : A 62-year-old woman was referred by her neurologist because of laryngeal discomfort, and saying that she can't open her eye lids smoothly. The patient had been healthy with no serious diseases until she noticed her illness about a year before. When she was admitted, she looked healthy and had no problem except for her chief complaints. In addition, she had received no medical treatment. After every possible examination, she was diagnosed to be suffering from apraxia of lid opening with globus hystericus and differenciated from blepharospasm or blepharoptosis by superficial EEG or clinical symptoms. There were no organic abnormalities that could cause this disease. It was revealed, however, that she was under psychosocial stress at the time of onset of her illness. After admission, her lids' symptoms improved gradually by client-centered psychotherapy without administration if any psychotropic drugs and finally she was cured in two and a half months. Judging from the process of therapy, her psychosocial characteristics and her globus gystericus as a complication, it is clear that her illness is Apraxia of lid opening due to a conversion mechanism.
日本心身医学会の論文
1990-02-01

ヒステリー転換症状による開眼失行の1症例

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