The Intravenous Diazepam Interview for Motor Paralysis Cases Influenced by Psychiatric Disorder

Abstract

Background: Motor rehabilitation may be rarely disrupted by psychiatric disorders including conversion disorder and catatonia. The amobarbital or diazepam interview can be implemented for both the diagnosis and treatment of these disorders. We report two typical cases presenting with motor paralysis influenced by psychiatric disorder that were effectively diagnosed and treated using the diazepam interview in convalescent rehabilitation. Cases: Case 1 was a 32-year-old man. He experienced severe paralysis and sensory disturbance of the right arm and leg while at work, and then received conservative treatment for stroke. One month later, after the diazepam interview, he rapidly recovered almost entirely from his paralysis and sensory disturbance, which led to a diagnosis of conversion disorder. Case 2 was a 42-yearold man. After becoming an alcoholic, both legs had gradually become severely paralyzed. Two months later, he was uncommunicative and refused rehabilitation and nursing care. He briefly became communicative during the diazepam interview, and was diagnosed with delusional depressed state with stupor. Six months later, both legs remained spastic and paralyzed. Although he was subacute with combined degeneration of the spinal cord, taking conversion disorder overlap into consideration, we conducted the diazepam interview again; he immediately recovered slight voluntary extension and flexion of both legs. Conclusions: We describe two motor disturbance cases influenced by psychiatric disorders. For both patients, the diazepam interview was shown to be an effective method for the diagnosis and treatment of a psychiatric disorder. Our findings suggest that the diazepam interview could be appropriate for use in the rehabilitation area when conducted correctly.