Conversion Disorder after Surgery in a Brain Tumour Patient
Bibliographic record
Abstract
We describe a case of conversion disorder in a young lady who had just been operated on for a glioma. CASE REPORTA 31-year-old lady presented two years ago with seizures manifesting as jerking of her right arm and leg.Neurological examination revealed no focal deficits.Brain imaging revealed the presence of a small lesion in her left mesial posterior frontal lobe, just anterior to the motor strip (Figure 1).The appearance was compatible with a low grade glioma.There was no perilesional edema, enhancement, or mass effect.She was treated with anti-epileptic medications with good control of her seizures.The brain tumour was managed conservatively with regular clinical and imaging follow-up.The patient remained well and asymptomatic, but her most recent magnetic resonance imaging (MRI) showed an increase in the size of the tumour (Figure 2).Awake craniotomy with cortical mapping for tumour excision was recommended and performed.Mapping over the motor cortex was positive, in that the right leg became weak when that area of cortex was stimulated.Corticotomy was made anterior to the motor cortex and aggressive subtotal resection of the tumour was achieved leaving behind a small cuff posteriorly, adjacent to the motor strip.As is our usual protocol, the patient was sedated after the mapping was performed, precluding continuous testing during tumour resection.Immediately post-operatively, the patient could not move her right leg.Motor examination was 5/5 for all limbs except for the right lower extremity which was 0/5 in all muscle groups.There was no sensory deficit.The patient had hyperreflexia bilaterally but no Babinski.She was noted to have a positive Hoover's sign, with palpable downward force of the right leg while raising the unaffected left limb.The patient's pattern of leg weakness exhibited some inconsistencies: despite a motor strength of 0/5, she was able to bear weight on her right leg and walk with support within two days.In addition, throughout the patient's hospital stay, she showed little concern about and seemed to be indifferent to her condition.Various investigations were carried out.Computed tomogram four hours after surgery and MRI 40 hours post-operatively both revealed the resection cavity in the left posterior frontal area anterior to the precentral gyrus, and a small amount of residual tumour between the surgical site and the motor strip (Figure 3).There was no hemorrhage, increase in the perilesional edema, or mass effect.Neurophysiologic studies such as nerve conduction velocity, electromyography, and motor evoked potentials done two weeks after surgery confirmed no organic brain pathology.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".