# Factitious Disorder Imposed on Self: Diagnostic Challenges and Clinical Lessons

## TL;DR

This paper discusses the challenges of diagnosing factitious disorder imposed on self through a case study of a woman with unexplained medical episodes.

## Contribution

The paper presents a clinical case highlighting diagnostic difficulties and management strategies for factitious disorder imposed on self.

## Key findings

- The patient's episodes lacked objective confirmation despite extensive testing.
- The case emphasizes the need for careful clinical evaluation and multidisciplinary management.
- Repeated invasive interventions occurred without clear diagnosis.

## Abstract

Factitious disorder imposed on self (FDIS), historically known as Munchausen syndrome, is characterized by the falsification or induction of symptoms in the absence of external incentives. We report the case of a 45-year-old woman with recurrent seizure-like and anaphylaxis-like episodes across multiple hospitalizations. Video electroencephalogram (EEG), laboratory, and imaging studies were inconclusive for both seizures and anaphylaxis. Her clinical course included recurrent unexplained presentations and repeated exposure to potentially invasive interventions despite the lack of objective diagnostic confirmation. This case illustrates the diagnostic challenges of FDIS and highlights the importance of careful clinical evaluation, minimizing iatrogenic harm, and a multidisciplinary management approach.