PDF(Pubmed)
Abstract：
Hand injuries typically present with localized symptoms. However, we report an unusual case of a 32-year-old female who experienced a transient complete loss of sensation and motor function in her entire left nondominant hand after sustaining a minor 1 cm stab wound between the third and fourth metacarpals. Wound exploration under local anesthesia revealed no tendon, vascular, neural, or bony injury. Remarkably, she spontaneously regained full hand sensation and function within 120 minutes of the injury. Extensive neurological evaluation, including magnetic resonance imaging (MRI), electromyography (EMG), nerve conduction studies (NCS), and somatosensory evoked potentials (SSEPs), ruled out organic pathology and supported a diagnosis of functional neurological disorder (FND), specifically functional movement disorder (FMD). Close collaboration between hand surgeons, neurologists, and occupational therapists is essential for accurate diagnosis and appropriate multidisciplinary management. Further research is needed to elucidate the mechanisms underlying FND and optimize evidence-based treatment for FND in the context of hand trauma. The increased awareness of this condition across specialties involved in hand injury management is crucial to facilitate timely diagnosis and avoid unnecessary interventions.
摘要：
手部受伤通常表现为局部症状。然而,我们报告了一例不寻常的病例,一例32岁女性,她的整个左非优势手在第三掌骨和第四掌骨之间有1厘米的轻微刺伤后,出现了短暂的感觉和运动功能完全丧失.局部麻醉下探查伤口未见肌腱，血管,神经,或者骨伤。值得注意的是,她在受伤后120分钟内自发恢复了全部的手部感觉和功能。广泛的神经系统评估，包括磁共振成像（MRI），肌电图（EMG），神经传导研究（NCS），和体感诱发电位（SSEP），排除了器质性病理学，并支持功能性神经障碍（FND）的诊断，特别是功能性运动障碍（FMD）。手外科医生之间的密切合作，神经学家,职业治疗师对于准确的诊断和适当的多学科管理至关重要。需要进一步的研究来阐明FND的潜在机制，并在手外伤的背景下优化FND的循证治疗。在手外伤管理中涉及的专业中提高对这种情况的认识对于促进及时诊断和避免不必要的干预至关重要。
