Paraplegia diagnosed by a new physical sign

Clinical diagnosis is a process of logical deduction from the data gathered by history and physical examination. When organic causes of an illness hav e been ruled out, a diagnosis of "functional disorder" or "conversion react ion" is considered. Cost of care of such patients can be enormous, especial ly when a large number of investigations are done to find an organic illnes s, which does not really exist. In such cases, a positive and early diagnos is of a conversion reaction can save needless tests and much distress to th e patient. This report describes a case of paraplegia that was investigated for years before a diagnosis of conversion reaction was firmly made, based on a novel observation, We believe that we describe here a new physical si gn, which can be used to diagnose "hysterical paraplegia."