man in a barrel syndrome
A fanciful term for reverse paraplegia characterised by severe arm weakness without leg weakness, which has been described in comatose patients who survive an episode of severe hypotension. The clinical findings have been attributed to a brain lesion, the location of which is uncertain, but may be bilateral and pre-rolandic.
The name derives from the fact that, like a man in a barrel, patients have full use of their legs while their upper body is paralysed.
While the imagery of an otherwise naked man wearing a barrel, held up by suspenders, is shorthand for dire financial straits or losing one’s shirt and thus extreme penury, it’s unclear how barrel wearing became linked to bankruptcy. Primarily seen in older cartoons, the custom may have originated in a punishment for public drunkenness in Germany and England, in which public drunks had to wear a beer barrel.
Synonyms Brachial diplegia, flail arm variant of motor neuron disease