Motionless and Clueless

CM is a 23 year-old male who consulted due to episodes of unexplained generalized morning paralysis.

About a year prior to consultation, the patient started experiencing morning paralysis described as "cannot move" any of his body parts except the opening of his eyes just when he's about to get out of the bed. According to him, he also cannot open his mouth and be able to speak, and he felt helpless during the attack. It was accompanied by anxiety, tachycardia (increase in heart rate) and tachypnea (increase in respiratory rate). During this first attack, he just resumed to sleep in the hopes that it's just a bad dream, then eventually after waking up he was able to move again.

Interim, the symptom occurred several times (~7) with the same manifestations. Sometimes when he cannot go back to sleep after the attacks, the paralytic episodes were resolved after a few minutes of waiting and just doing nothing. He just ignored these attacks cos all were resolved eventually and spontaneously.

Not until a few days prior to consultation, the patient had the same attack however at this time, it's accompanied by an unexplained sight of a young woman seated beside his bed. He claimed that he doesn't know the woman but was initially considered to be his older sister. He cannot confirm this for he can only see the back of her head and not the face of the woman. During the attack, he tried to check the identity of the woman but since he cannot move, it was unsuccessful.

This attack was considered as horrifying by the patient hence consultation.

Other relevant histories:

*No previous deaths in the family and friends
*No signs and symptoms of organic brain lesion
*No family history of psychiatric disorders
*Often late and absent in school
*Occasional alcoholic beverage drinker
*Patient denied of any illicit drug use

On physical examination, the patient is lanky, sluggish and looks always exhausted. He eats slowly but would eventually finish his meal. No pertinent neurologic and psychiatric signs. The rest of the PE was unremarkable.

First of all, this is my first entry under BlueNotes. Yey!

To be totally honest, I was terrorized when the patient told me this uncanny experience. The story was filled with fear and questions like "what happened to me?!"

My initial impression was that it's a possible paranormal experience. Why not?! Right? It's also possible that the inability to move after waking up in the morning might be due to possession by some sort of evil or wandering spirit that may have corrupted his body, right? But to be honest, I don't believe in such ideas, cos I personally don't have any previous ghostly experiences.

Still... and what the heck! When one tells us stories such us this, we cannot erase considering something eerie and spooky. It triggers goosebumps from erupting all over our skins.

I considered asking opinions about this case to some people that I knoe and they pretty much have the same impression. They don't know what it was but they were sure that "it's not something explainable by simple psyche."

So if the patient actually experienced something paranormal and saw a ghost, then who is this lady ghost? The patient as stated in the history had no recall of any previous deaths in the family nor friends that may explain the apparition. Is there a medical explanation to his experience?

Differential diagnoses?

  • Visual hallucination, an early symptom of schizophrenia.
  • CM is a drug addict. He lied when he denied illegal drug use.
  • Metastatic malignancy (cancer) with involvement of the brain causing visual hallucination and also probably the episodic paralysis.
  • Periodic paralysis.
  • CM has a friend who unknowingly just died.
  • CM just made up the story.
  • The lady ghost was just his sister. He panicked.

    Actually, different people will make different impressions on this case. In the real world, people would go to where their beliefs would tell them which is more or less true. It feels safer when we act into our own concept and beliefs and it is easier to prove (it) if we knoe a lot of things about it.

  • Same is true in medicine, doctors nowadays don't just say it's a medical case but instead would further correlate it to the type of specialty or subspecialty he is expert about. That's is why it is relatively not advisable to go directly into a specialist for a first consultation but rather to go to a general practitioner first to evaluate the real causality of symptoms.

    For example. If you experience chest pains, a Pulmonologist will likely tell that you have a pleural effusion secondary to pneumonia. A Cardiologist will likely say you have an angina or worse MI. A Rheumatologist will likely say you have an arthritis.

    So for me based on my own opinion, I think CM had episodes of periodic paralysis. It feels safer for me to say that cos I knoe all the symptoms fit. Besides, ion't believe in paranormal "weirdo-ness". No offense but I really don't.

    Periodic paralysis is a rare genetic diseases that lead to weakness or paralysis from common triggers such as cold, heat, high carbohydrate meals, not eating, stress or excitement and physical activity of any kind. In Asia, hyperthoiroidism is also one of the triggers or causes of periodic paralysis.

    So, what do you think?

    5 remark(s):

    Mugen said...

    Remember what I told you over dinner before? Hehehe. Oh well, science and paranormal can never see eye to eye.

    Zai Zai said...

    i actually had this experience but it only occurred once. I researched about it and found it was the old hag phenomena. what happens is same as you stated, and it was what I experienced too. I found about it on wikipedia and it was made to look like a paranormal thing. I'm just not sure how it is possible that it would occur in several occasions.

    Camille said...

    huh? anu to? bat may history dto? haha nerd.. wait ill try to read... shempre as usual di ko nanaman binasa! haha

    Camille said...

    ah.. kilala ko to... hhehe.. pero parang dream lang din sha na gising ka na.. madalas mangyari to sakin sa dorm dati.. ngayon minsan nalang...

    Camille said...

    rare ba to? genetic?? haha.. pareho pa kami ng initials nun male patient mo..

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