• Sohrab Naushad Ali Northwest General Hospital and Research Centre, Peshawar
  • Aymon Naushad Ali Northwest General Hospital and Research Centre, Peshawar
  • Mian Naushad Ali Northwest General Hospital and Research Centre, Peshawar


Münchausen Syndrome by Proxy (MSBP) is a psychiatric disorder characterised by the adoption of bizarre behavioural patterns by care-givers in which diseases or disorders are fabricated in individuals, usually children, for purposes which span feelings of superiority derived from deceit of persons deemed superior to the care-giver, or attention seeking. The patient under discussion was a 6 year old male brought to the hospital by his mother with complaints of repetitive and unceasing passing of stones per urethra. Upon inspection of stone specimens brought in by the parents and physical examination, the stones in question were observed to be common stones, with no reason to suggest a urolithiatic origin, leading to the suspicion of MSBP. Further questioning of both the mother and father revealed more information regarding the cause of her child's illness and strongly suggested that the stones were being physically inserted into the child's urethra by the mother - often in the father’s absence - after administration of sedative-hypnotic drugs.              Keywords: Münchausen Syndrome by Proxy, Münchausen Syndrome, behaviour, care-giver


Meadow R, Lennert T. Munchausen by Proxy or Polle Syndrome: Which Term Is Correct? Pediatrics 1984;74(4)554–6.

Leonard KF, Farrell PA. Münchausen's syndrome by proxy. A little-known type of abuse. Postgrad Med 1992;91(5):197–204.

Stirling J Jr. Beyond Munchausen syndrome by proxy: identification and treatment of child abuse in a medical setting. Pediatrics 2007;119(5):1026–30.

McGuire TL, Feldman KW. Psychologic Morbidity of Children Subjected to Munchausen Syndrome by Proxy. Pediatrics 1989;83(2):289–92.

Galpin R, “Pakistan's Wall of Silence on Child Abuse”, BBC (Online issue), Jan. 1999

Schreier H. Munchausen by proxy defined. Pediatrics 2002;110(5):985–8.

Asher R., “Munchausen's syndrome”, Lancet 1951;1(6):339–41

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text Rev. Washington, DC: American Psychiatric Association; 2000:513

Sheslow, D.V. & Gavin-Devitt, L.A., "Munchausen by proxy syndrome", 2008, KidsHealth

Sahin F, Asli K, “Munchausen Syndrome: A Case Report”, Turkish J Pediatr 2001;44:334–8

Payne, Stewart, "Joy for mother cleared of baby deaths”, The Telegraph, 12th June, 2003.

Schreier, H.A. and Libow, J.A. “Munchausen Syndrome by Proxy: Diagnosis and Prevalence”, American Journal of Orthopsychiatry, 1993, 63(2):318–21.

Vennemann B, Perdekamp MG, Weinmann W, Faller-Marquardt M, Pollak S, Brandis M., "A case of Munchausen syndrome by proxy with subsequent suicide of the mother", Forensic Sci Int 2006;158(2-3):195–9.