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La belle indifférence revisited: a case report on progressive supranuclear palsy misdiagnosed as conversion disorder

Overview of attention for article published in Neuropsychiatric Disease and Treatment, August 2017
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Title
La belle indifférence revisited: a case report on progressive supranuclear palsy misdiagnosed as conversion disorder
Published in
Neuropsychiatric Disease and Treatment, August 2017
DOI 10.2147/ndt.s130475
Pubmed ID
Authors

Petra van Meerkerk-Aanen, Lars de Vroege, David Khasho, Aziza Foruz, J. Thies van Asseldonk, Christina van der Feltz-Cornelis

Abstract

Since the advent of computed tomography and magnetic resonance imaging scans, neurological disorders have less often been falsely labeled as conversion disorder (CD). However, misdiagnosis of a neurological disorder as CD still occurs, especially in cases with insidious onset. Misinterpretation of la belle indifférence may contribute to such misdiagnosis. Here, we describe a case of progressive supranuclear palsy/Richardson's syndrome (PSPS) misdiagnosed as a case of CD. A 62-year-old woman consulted two different neurologists in 2012 because of falling spells since 2009 and was diagnosed with CD. She was referred to the Clinical Center of Excellence for Body, Mind, and Health for treatment of CD. After neurological examination, blood tests, and psychiatric examination, in which la belle indifférence and a history of incest were found, CD was confirmed. However, despite treatment for CD, the patient's physical symptoms deteriorated over a year. After repeated physical and psychiatric examinations, neurocognitive assessment, and consultation with a third neurologist because of suspicion of neurological disease, the patient was diagnosed with PSPS. La belle indifférence may be a psychological sign in the context of CD, but it may also be an expression of lack of mimic due to Parkinsonism or of eye movement disorder in the context of neurological illness. A diagnosis of CD should not be considered definitive if no improvement occurs in terms of physical, mental, and cognitive symptoms despite appropriate therapy. In case of deterioration, neurological reexamination and reinterpretation of la belle indifférence should be considered.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 42 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 42 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 6 14%
Student > Master 5 12%
Student > Doctoral Student 4 10%
Student > Postgraduate 4 10%
Professor 3 7%
Other 8 19%
Unknown 12 29%
Readers by discipline Count As %
Psychology 11 26%
Medicine and Dentistry 8 19%
Nursing and Health Professions 4 10%
Sports and Recreations 1 2%
Social Sciences 1 2%
Other 2 5%
Unknown 15 36%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 March 2018.
All research outputs
#11,040,215
of 14,537,474 outputs
Outputs from Neuropsychiatric Disease and Treatment
#1,701
of 2,487 outputs
Outputs of similar age
#183,354
of 269,093 outputs
Outputs of similar age from Neuropsychiatric Disease and Treatment
#51
of 89 outputs
Altmetric has tracked 14,537,474 research outputs across all sources so far. This one is in the 20th percentile – i.e., 20% of other outputs scored the same or lower than it.
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