Medically unexplained neurological symptoms

We report a case of medically unexplained quadri-plegia following lumbar decompression and discuss the management of this type of problem. Case history A 56-year-old woman with seronegative polyar-thritis presented with a four-year history of lower back pain and right-sided sciatica. On exam-ination she had reduced power and impaired sensation in her right leg. Magnetic resonance imaging (MRI) of the spine revealed anterior degenerative slip of L4 on L5 with moderate overall reduction in canal calibre and osteophyte encroachment in the right lateral recess at that level, causing compression of the right L5 nerve root. The facet joints were subluxed and there wa