Titre
Validity of the "Drift without pronation" sign in conversion disorder.
Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
Auteur(s)
Daum, C.
Auteure/Auteur
Aybek, S.
Auteure/Auteur
Liens vers les personnes
Liens vers les unités
ISSN
1471-2377
Statut éditorial
Publié
Date de publication
2013
Volume
13
Numéro
31
Première page
1
Dernière page/numéro d’article
3
Langue
anglais
Notes
Publication types: Journal ArticlePublication Status: epublish. PDF type: Research article
Résumé
BACKGROUND: Conversion disorder (CD) is a psychiatric disorder, yet the diagnosis cannot be established without the expertise of a neurologist, as distinguishing a functional from an organic symptom relies on careful bedside examination. Joseph Babinski considered the absence of pronator drift as a 'positive sign' for hysterical paresis but the validity of this sign has never been evaluated. The aim of this study was to examine the sensitivity and specificity of the "drift without pronation" sign.
METHODS: Twenty-six patients with unilateral functional upper limb paresis diagnosed with CD (DSM-IV) and a control group of 28 patients with an organic neurological condition were consecutively included. The arm stabilisation test was performed with arms stretched out in full supination, fingers adducted, eyes closed for 10 seconds. A positive "drift without pronation" sign was defined by the presence of a downward drift without pronation.
RESULTS: All CD subjects (100%) displayed a positive sign when only 7.1% of organic subjects did (Fisher's p < 0.001). The sign yielded a sensitivity of 100% (95% CI:84%-100%) and a specificity of 93% (95% CI:76%-98%).
CONCLUSION: The observation of a "drift without pronation" sign is specific for Conversion Disorder and can be of help in making a quick distinction between organic and functional paresis at the bedside.
METHODS: Twenty-six patients with unilateral functional upper limb paresis diagnosed with CD (DSM-IV) and a control group of 28 patients with an organic neurological condition were consecutively included. The arm stabilisation test was performed with arms stretched out in full supination, fingers adducted, eyes closed for 10 seconds. A positive "drift without pronation" sign was defined by the presence of a downward drift without pronation.
RESULTS: All CD subjects (100%) displayed a positive sign when only 7.1% of organic subjects did (Fisher's p < 0.001). The sign yielded a sensitivity of 100% (95% CI:84%-100%) and a specificity of 93% (95% CI:76%-98%).
CONCLUSION: The observation of a "drift without pronation" sign is specific for Conversion Disorder and can be of help in making a quick distinction between organic and functional paresis at the bedside.
PID Serval
serval:BIB_47E7EF18A500
PMID
Open Access
Oui
Date de création
2013-05-03T18:40:02.538Z
Date de création dans IRIS
2025-05-20T14:58:51Z
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Nom
BIB_47E7EF18A500.P001.pdf
Version du manuscrit
preprint
Taille
128.33 KB
Format
Adobe PDF
PID Serval
serval:BIB_47E7EF18A500.P001
URN
urn:nbn:ch:serval-BIB_47E7EF18A5001
Somme de contrôle
(MD5):7f6f8ea027c6db101e169ec1da05a589