A 27-year-old female presents to the ED with paralysis of her left arm. A thorough medical workup (including labs, chemistries, EMG, and neuroimaging) is unremarkable. She denies any recent trauma or injury to the left arm but reports a recent history of miscarriage. A staff member witnesses the patient moving her left extremity when distracted or dressing, and this is corroborated by the medical resident who noted contraction of the tricep muscle while testing bicep strength (co-contraction sign) on exam. The patient requests to be discharged and does not seem interested in receiving medical care or a diagnosis.

Which of the following is the most likely diagnosis?

A. Malingering
B. Transient ischemic attack
C. Brachial plexus injury
D. Functional neurological symptom disorder

Question

24-01-2025
Medicine

College

We appreciate your visit to A 27 year old female presents to the ED with paralysis of her left arm A thorough medical workup including labs chemistries EMG and neuroimaging. This page offers clear insights and highlights the essential aspects of the topic. Our goal is to provide a helpful and engaging learning experience. Explore the content and find the answers you need!

A 27-year-old female presents to the ED with paralysis of her left arm. A thorough medical workup (including labs, chemistries, EMG, and neuroimaging) is unremarkable. She denies any recent trauma or injury to the left arm but reports a recent history of miscarriage. A staff member witnesses the patient moving her left extremity when distracted or dressing, and this is corroborated by the medical resident who noted contraction of the tricep muscle while testing bicep strength (co-contraction sign) on exam. The patient requests to be discharged and does not seem interested in receiving medical care or a diagnosis.

Which of the following is the most likely diagnosis?

A. Malingering
B. Transient ischemic attack
C. Brachial plexus injury
D. Functional neurological symptom disorder

Answer :

Other Questions

The sum of the first 7 terms of an arithmetic progression (AP)

Convert to Celsius using the formula [tex]C = \frac{5}{9} (F - 32)[/tex],

To estimate intrapulmonary shunt using the modified shunt equation, blood gas samples

Where was the film "The Silent Call" set? A. New York B.

Identify the adjective in each sentence and select the correct answer. 1.

Task Instructions: Add OR criteria to the `WorkshopAttendanceByType` query to select only

The idea that speech must present a danger that is immediate and

Under which Persian ruler did the Empire reach its greatest extent?

Which cream cheese has the lowest price per ounce? A. $5.29 for

Pair each noun phrase with its opposite on the right: 6. a

CalvinnBrooks CalvinnBrooks · Answer 1 · 2023-07-22T06:19:46-04:00

D. Functional neurological symptom disorder is the most likely diagnosis for the patient presenting with left arm paralysis in the Emergency Department.

Functional neurological symptom disorder is characterized by neurological symptoms that are incompatible with known neurological or medical conditions.

The patient's symptoms, lack of findings on medical workup, and the observation of movement when distracted or not focusing on the symptoms are consistent with this diagnosis.

The recent history of miscarriage may also suggest an underlying psychological stressor contributing to the presentation. Malingering involves intentionally feigning or exaggerating symptoms for secondary gain, which does not seem to be the case here.

A transient ischemic attack would typically present with acute neurological deficits due to vascular compromise, which is not supported by the findings. Brachial plexus injury would have identifiable anatomical or electrophysiological abnormalities.