One day in the emergency department of internal medicine just after the night shift, the pre-screening nurse rushed to inform that the 120 ambulance would soon send an unconscious male patient, please be prepared to resuscitate, so I immediately rushed to the emergency resuscitation room, not long from the whistling ambulance carried off a young man of about 26, 7 years old, foaming at the mouth limbs keep twitching, medical staff busy to immediately start resuscitation work, oxygen, open veins, but the electrocardiogram and blood pressure check all normal, vital signs stable, routine laboratory tests did not provide other clues. However, the electrocardiogram and blood pressure check were normal, the vital signs were stable, and the routine laboratory tests on the emergency vehicle did not provide other clues as to what caused the patient’s unconsciousness was the key to further treatment. Was it an interictal seizure? But it has been nearly half an hour since the onset of the seizure was delivered to the resuscitation room, has it been that long since the interictal grand mal seizure? Was it alcohol poisoning? But he did not have the usual intoxicated person’s mouth full of alcohol. Was it suicide by drugs? Drug poisoning? Hypoglycemic coma? Liver coma? There was no conclusive diagnosis. When I asked the patient’s girlfriend who accompanied her to the hospital about the onset of her seizure, she only said that she met with her boyfriend who came to pick her up from work and was still fine, then she went to borrow a cell phone from her hometown to make a phone call, and when she returned to her room, she found her boyfriend passed out on the floor, and usually her body was healthy and did not have any chronic diseases. The patient’s eyes seemed to be open, and the patient’s eyes could be seen to be rotating, and her mind seemed to be awake. Using the orbital reflex, the patient’s teeth were tightly closed and the face muscles were tense and taut, and there was no frowning movement that should occur. The patient’s coma symptoms were suspicious, so I asked the patient’s girlfriend if she had received any mental stimulation today. His girlfriend started to stare, but later confided that she had had several arguments with her boyfriend today. Could the patient be a kind of hysteria? So while his girlfriend left the resuscitation room to call his gay family, the doctor asked the patient loudly to the patient card you are called Zhang so-and-so? This year 27 years old did not write wrong, right? The patient in a coma actually nodded and said yes. Then the patient’s limbs did not shake, breathing was stable, and opened his eyes to look around. However, when the patient’s girlfriend came to visit with the patient’s family, the patient started to have irregular shaking of his limbs again, his teeth were closed, he was breathing rapidly, and he was not able to call out, which made the family terrified. The recurrence of the disease made the doctor more confident in the diagnosis. The doctor immediately explained the condition to the family in front of the patient, saying that his disease had been identified and was now being treated with special drugs intravenously, and that everything would soon improve. After being hinted at, the patient did gradually stop shaking his limbs and quieted down. Shortly after, the patient, who was receiving an infusion, woke up and asked to get out of bed to urinate. So the doctor asked the family to accompany the patient to the toilet, and when he returned, the patient no longer wanted to stay in the resuscitation room for rehydration, so the doctor asked the patient’s girlfriend to accompany him to continue treatment in the emergency room rehydration room. Not long after the two bottles of saline drip, two hours ago by ambulance to the hospital unconscious patients, and girlfriend intimate hand in hand out of the hospital emergency room door. At this point, the diagnosis of hysteria for the young man who was sent to the hospital for emergency care because of the coma was very clear, belonging to the typical grand mal of hysteria, the somatic disorder of hysteria. In fact, in the emergency department of a general hospital, patients like this can be met almost every day, so it is very meaningful to master the diagnosis and identification of hysteria to improve the diagnosis rate and treatment efficiency of emergency treatment. Hysteria is a neurological disorder in the category of psychological disorders, also known as hysteria, or pretend symptoms, that is, psychological problems manifested in a tortuous form, transformed into a disease-like symptoms, clinicians often referred to as HY. but different from the general neurological disorders, because hysterical patients do not have the general neurological patients have self-awareness, feel pain, have a strong But it is different from general neurosis because patients with dysthymia do not have the characteristics of general neurosis such as self-awareness, feeling pain, having a strong desire to seek treatment, and not having pathological psychiatric symptoms, and thus have their own special characteristics. Hysteria often has a rapid onset and is usually preceded by psychosocial stimuli, but these are the trivialities of daily life and general conflicts in interpersonal relationships, such as quarrels between lovers and couples, family conflicts, disputes between colleagues and neighbors, parents and teachers teaching children, etc. Strong stimuli are rare. The clinical manifestations of hysteria are mainly different types of hysterical symptoms, the so-called hysteria, that is, hysterical symptoms, is the patient’s imagination or once saw the symptoms of various diseases in the surrounding people, such as shortness of breath similar to asthma patients, epilepsy patients with twitching limbs, can involve all systems, and the degree of hysterical symptoms similar to the real disease is related to the patient’s knowledge of such diseases, the more thorough the understanding of the disease, the more knowledgeable the patient is. The more thorough the understanding of the disease and the higher the level of knowledge, the more its performance resembles the real disease, and sometimes it is confusing and difficult to decompose for a while. However, after careful history taking and examination, it can be found that there is a lack of pathological anatomy and pathophysiological basis for the pathogenesis of the disease, and that the symptoms can flare up, worsen, remit, reduce, or even disappear with psychological suggestion in the course of the disease. Specifically, although the manifestations of hysteria symptoms can be varied, they can be broadly classified into two categories: hysterical mental disorder and hysterical somatic disorder. The most common hysterical mental disorder is emotional outburst, the patient can be a lot of hair, rolling on the ground, bawling, hoarse, desperately want to pour out the heart full of grievances and anger, serious can even appear hallucinations, injury, destruction and self-harm behavior, other hysterical mental disorders are: hysterical amnesia, hysterical roaming, hysterical pseudo-dementia, hysterical alternating personality, the emergence of such mental abnormalities It is easy for clinicians to identify these mental abnormalities, and it is not difficult to distinguish them from general somatic organic disorders. Hysterical somatic disorders can be divided into hysterical grand mal seizures, hysterical sensory disorders, hysterical motor disorders, such as hysterical aphasia (inability to speak but cough), hysterical paralysis (various types of physical disorders but no corresponding clinical features of neurological damage), hysterical tremor (random and irregular limb tremors), hysterical blindness, hysterical deafness, hysterical cutaneous sensory The most common of these is the hysterical grand mal seizure, which is often distinguished from all kinds of somatic diseases affecting the state of consciousness, especially important. White end (for the saliva in the mouth), the patient does not fall to the ground in the process of bruising, incontinence, bite tongue, etc., the pupils of comatose patients have good reflexes to light, pick open the eyes of patients will turn non-stop, so as long as careful observation of patient performance can still find clues, so that the corresponding basic examination can be found where the symptoms. To summarize, the main points of diagnosis of hysteria are as follows: 1 sudden onset 2 often occurs in healthy people without a history of organic disease, often related to their special personality, the so-called hysterical personality disorder, especially in young women 3 there must be psychosocial stimuli before the onset 4 hysterical symptoms do not conform to the corresponding pathological anatomy and pathophysiological lesion law. 5 hysterical symptoms can occur, aggravate and relieve, and even disappear because of psychological suggestion. The persistence of hysterical symptoms is related to the psychological support from the surrounding environment and the secondary benefits obtained after the onset of the illness.6 Other psychiatric and somatic disorders need to be excluded.