The term Munchausen syndrome—named after the famed 18th century Baron Munchausen of Germany, whose wide travels and notorious tall tales have inspired literature pieces, several films, and even a popular game— was originally coined in 1951 by Dr. Richard Asher, a British endocrinologist and hematologist who used the term to refer to patients who feign illness.1 Today, most experts use it to des...

One of the challenges in acute stroke management is accurately differentiating between actual ischemic events and other conditions that mimic stroke. In a cohort of 821 consecutive patients admitted to an acute stroke unit, 13% were incorrectly diagnosed as stroke [1]. In another cohort of 411 patients, it was estimated that 19% of patients presenting to the emergency department with stroke-lik...

I congratulate the authors of the recently revised ‘‘BSG guidelines for the investigation of diarrhoea’’ for their excellent overview of this important clinical problem.(Gut 2003; 52(suppl V):v1–15). I would however take issue with the suggestion that measurement of stool volumes in outpatients is impractical. In my experience such measurement is readily achievable and cheap, merely requiring a...

Psychogenic symptoms are common and pose an uncomfortable challenge. Among psychogenic symptoms, psychogenic nonepileptic seizures (PNES) are common and have been extensively studied. They are unique in that, unlike most other psychogenic symptoms, they can be diagnosed with near certainty. PNES can be used as a model, as almost everything that applies to PNES applies to other psychogenic sympt...

Using single electron capacitance spectroscopy, we study electron additions in quantum dots containing two potential minima separated by a shallow barrier. Analysis of the addition spectra in the magnetic field allows us to distinguish between electrons delocalized over the entire dot and those localized in either of the potential minima. We demonstrate that a high magnetic field abruptly split...

The Munchausen's syndrome (MHS) is a rare psychiatric disorder classified among the self-manipulated diseases. Incidence of Munchausen syndrome peaks in young-to-middle-aged adults, but it has been reported in patients of all ages (ie, childhood through advanced age). Diagnosing Munchausen syndrome is very difficult, but early diagnosis could to a considerable extent prevent the iatrogenic risk...

BACKGROUND Repeated case series have documented the effectiveness of multidisciplinary in-patient behavioural treatment for conversion disorders. However, in the absence of controlled research, treatment success could be attributed to providing patients with a face-saving opportunity to get better. AIMS The present study contrasts two behavioural treatments to elucidate the factors underlying...

Chronic factitious disorder, Munchausen's syndrome, can be challenging to manage-particularly when complaints and symptoms suggest medical or surgical emergencies. We present a patient whose problems have spanned many years and a great distance. Hopefully, with a greater awareness of this disease, as this patient continues to seek health care in many different hospitals, the implications of tim...

Thirty-three patients who had various conversion reactions manifested by signs and symptoms involving the upper extremities were seen over a 13-year period. Factitious lymphedema, factitious ulcers, clenched fists, as well as other dysfunctional postures of the hand and upper extremity, were the most frequently recognized patterns of illness. Denial of knowledge of the cause of the physical pro...