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münchhausen's syndrome by proxy


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  • This term refers to a peculiar form of child abuse. In most cases it is the mother inventing symptoms and fabricating signs in relation to her child, and thus causing the child painful and unnecessary physical examinations and treatments. Epilepsy is the commonest. In the 'active' form she induces anoxia and seizures by suffocating the child for a few moments, as by pressing the child's face against her bosom. In the 'passive' form she complains or teaches the children to complain that the child experiences fits or other conditions such as diarrhoea, abdominal colic, haematemesis, haematuria or apnoic attacks.

    When the child suffers from apnoea induced by a parent the disorder is called Münchhausen’s syndrome by proxy and apnoea.

    Children who have been brought up in this way can take over the illness pattern themselves and lead a life of invalidism or repeatedly present themselves to hospital with stories of imaginary illnesses (like a vagrant will Münchhausen's syndrome).

    The condition was named after Polle, the son of baron Hieronymus Karl Friedrich von Münchhausen and his second wife, Bernhardine Brun, who was born in 1795 and died 1 year later. The syndrome is considered to be a form of the battered child syndrome.

    The term "Münchhausen's syndrome by proxy" was coined in 1976 by J. Money and J. Werlwas. They described a case of dwarfism caused by starvation in which the parents presented misleading accounts of the child’s illness. Roy Meadow used the term in 1977, and in 1984 Roy Meadow and Thomas Lennert demonstrated that the term Polle's syndrome was based on a historical error.

    * J. Money and J. Werlwas:

    Folie a deux in the parents of psychosocial dwarfs: two cases.

    Bulletin of the American Academy Academy of Psychiatry and the Law, 1976, 4 (4): 351-362.

    * R. Meadow:

    Munchausen syndrome by proxy: The hinterland of child abuse.

    The Lancet, London, 1977, II: 343-345.

    * D. Burman, D. Stevens:

    Munchausen family. The Lancet, London, 1977, 2: 456.

    * R. Meadow, Th. Lennert:

    Munchausen by proxy or Polle syndrome. Which term is correct?

    Pediatrics, Evanston, Illinois, 1984, 74: 555-556.

    December 1, 2008