Video NeuroImage: diagnosing conversion weakness with the Spinal Injuries Center test: when Hoover doesn't help.

W. Curt LaFrance, Jr., MD, MPH The Hoover sign has been used since 1908 to aid in diagnosing conversion paralysis in unilateral lower extremity weakness. The abductor sign tests the same finding in the horizontal plane.1 Recently the Spinal Injuries Center (SIC) test has been shown to be a highly sensitive and specific sign for lower extremity weakness.2 Patients who are unable to raise their knees spontaneously are considered to have a positive SIC test (confirming conversion paralysis) when their knees maintain the lifted position after being placed by the examiner. The videos demonstrate the SIC test in unilateral hemiplegia, paraplegia, and conversion weakness.