The factitious disorder by proxy or “syndrome of Münchhausen by proxy” is the production of symptoms to a child by a mistreating adult who wishes to play the sick role through this child. the medical profession becomes itself maltreating by scheduling more and more invasive additional examinations and the mortality would be 5%. the disease by proxy questions the clinicians in front of its unusual form and its absence of anatomo-clinical parallelism: the symptoms most frequently presented are sleep apneas and convulsions. If all somatic symptoms were described, forms of artificial disorder by proxy with psychiatric expression are underestimated. After a review of the literature on the syndrome of Münchhausen by proxy on one hand and its psychiatric expression on the other hand, we shall explain a clinical case illustrating this atypical presentation. the diagnostic of factitious disorder by proxy and its psychiatric expression is very complex. the child can present an authentic psychiatric disorder establishing a differential or tangled diagnosis. This victim can develop psychological aftereffects of this child abuse like behavioural problems. the child can even secondly participate to the presentation of the symptoms in a morbid alliance with the simulated parent. We shall return on diagnostic and therapeutic measures of care to offer to the maltreated child but also to the parent too, whose psychopathological determiners will be useful to clarify.