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NEUROLOGY 2008;71:e57
© 2008 American Academy of Neurology
Resident and Fellow Section

Video NeuroImage: Diagnosing conversion weakness with the Spinal Injuries Center test

When Hoover doesn’t help

Formula

W. Curt LaFrance, Jr, MD, MPH

From the Division of Neuropsychiatry and Behavioral Neurology, Rhode Island Hospital, and Departments of Neurology and Psychiatry (Research), Brown Medical School, Providence, RI.

Address correspondence and reprint requests to Dr. W. Curt LaFrance, Jr., Rhode Island Hospital, 593 Eddy Street, Potter 3, Providence, RI 02903 William_LaFrance_Jr{at}Brown.edu

The Hoover sign has been used since 1908 to aid in diagnosing conversion paralysis in unilateral lower extremity weakness. The abductor sign tests the same finding in the horizontal plane.1 Recently the Spinal Injuries Center (SIC) test has been shown to be a highly sensitive and specific sign for lower extremity weakness.2 Patients who are unable to raise their knees spontaneously are considered to have a positive SIC test (confirming conversion paralysis) when their knees maintain the lifted position after being placed by the examiner.

The videos demonstrate the SIC test in unilateral hemiplegia, paraplegia, and conversion weakness.

Supplemental data at www.neurology.org

Disclosure: The author reports no disclosures.


   REFERENCES
Top.
 REFERENCES
 

  1. Sonoo M. Abductor sign: a reliable new sign to detect unilateral non-organic paresis of the lower limb. J Neurol Neurosurg Psychiatry 2004;75:121–125.[Abstract/Free Full Text]
  2. Yugué I, Shiba K, Ueta T, Iwamoto Y. A new clinical evaluation for hysterical paralysis. Spine 2004;29:1910–1913.[Medline]




This Article
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Related Collections
Right arrow Clinical neurology examination
Right arrow All Movement Disorders
Right arrow Dystonia
Right arrow Conversion
Right arrow Spinal cord infarction

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