Stabbing nails into the neck: an unusual self-damaging behaviour mandating neurosurgery.

Abstract

Patients with Munchausen's syndrome deliberately simulate symptoms of an illness to gain hospital admission and the attention of healthcare providers. Although rare, it is possibly under-recognized and leads to diagnostic dilemmas. The main features of the condition include the recurrent nature of the illness, repeated similar presentations, visiting different hospitals with the same complaint, and leaving treatment once the motive is discovered. The usual presentations are neurological or abdominal complaints. The origin of the condition is unknown but there is a suggestion that patients may have sustained brain damage prior to the beginning of their hospital addiction. Since their motivation is unknown, personality disorder and psychopathy have been suggested as probable causes.