RT Journal Article
SR Electronic
T1 Munchausen Syndrome by Tissue Plasminogen Activator
JF Neurology: Clinical Practice
FD Lippincott Williams & Wilkins
SP 64
OP 68
DO 10.1212/CPJ.0000000000000828
VO 11
IS 1
A1 Willenberg, Rafer
A1 Leung, Bo
A1 Song, Shlee
A1 Dumitrascu, Oana M.
A1 Schlick, Konrad
A1 Lyden, Patrick
YR 2021
UL http://cp.neurology.org/content/11/1/64.abstract
AB Purpose of Review Munchausen syndrome by tissue plasminogen activator (tPA) is a phenomenon we describe as patients exhibiting factitious symptoms to assume the role of the sick patient, desiring and received tPA, with no alternative diagnosis or secondary gain to better account for their presentation. To illustrate this phenomenon and its magnitude, we present a series of cases of Munchausen syndrome by tPA, prevalence in our stroke center, and highlight one illustrative case.Recent Findings Of 335 cases with tPA administration over 29 months, 10 were confirmed as Munchausen syndrome by tPA, reflecting a 3.0% prevalence in our stroke center.Summary Munchausen syndrome by tPA is an underappreciated phenomenon encountered in evaluating patients with acute stroke symptoms. Administering tPA in Munchausen syndrome poses an ethical dilemma because standard of care favors rapid tPA administration, but administration can cause harm, burdens the healthcare system, and does not treat the patient's Munchausen syndrome.