ABSTRACT

This chapter provides a case of a 19-year-old woman who presents to her general practitioner (GP) saying that she is unable to open her fists. She says that 3 days ago she woke up and found it to be like this. She says she also started to see in black and white for a few hours and could see no colours. The fists are tightly closed and on gentle examination it is not possible to open the fingers. There is clear resistance to movement. The woman does not appear to be unduly concerned. A neurological examination reveals no other abnormalities. On mental state examination she makes good eye contact and smiles readily. She sits with her fists clenched as if holding ski poles with the thumbs slightly rotated into the midline. There is no agitation, restlessness or retardation of movements. She describes no low mood and appears euthymic. There is no evidence of thought passivity, hallucinations or delusions.