Astasia-Abasia and Ganser syndrome in a preadolescent girl: A case report

Abstract

Introduction. Astasia is the inability to maintain an upright body position without assistance in the absence of motor weakness or sensory loss. Abasia is described as the inability to walk or as uncoordinated walking, while preserving mobility of the lower limbs. Ganser syndrome is described as a dissociative disorder characterized by approximate answers, somatic conversion symptoms, clouding of consciousness, as well as visual and auditory pseudohallucinations. The aim of this study is to present a case that seemed like a combination of neurological and internal disturbances, but actually represented a psychogenic disorder. Case Outline. This paper presents the case of a 13-year-old patient with the first manifestation of the inability to walk and stand. Medical history, diagnostic instruments and differential diagnostic methods have been presented in detail. The clinical manifestation was initially interpreted as a neurological disorder. However, after the application of diagnostic procedures and a change in family circumstances, the patient was diagnosed with a psychogenic movement disorder, astasia-abasia, with progressive clinical presentation that included dissociative psychotic reactions (Ganser syndrome). Differential diagnosis as well as the elements of the therapeutic approach have been discussed. Conclusion. Presenting a case of psychogenic astasia-abasia in children contributes to a better understanding and differentiating between conditions with a clinical presentation of signs and symptoms dealt with by other branches of medicine.