Conversion disorder

Background

     * One or more symptoms that involve motor or sensory neurologic function believed to be related to a psychiatric condition.
     * The symptoms are not intentionally produced
     * Diagnosis of exclusion
     * Often associated with patient who is unconcerned or neutral to the loss of motor/sensory function

Differential Diagnosis

     * Malingering
     * Hypokalemic Periodic Paralysis
     * Multiple Sclerosis
     * Myasthenia Gravis
     * Stroke
     * Guillain-Barre Syndrome
     * Spinal Impingement/Epidural Abscess

Diagnostic Studies

     * All test will be negative: should consider CT, CBC, CHEM 10, LP, Possible MRI if concerned for spinal pathology

Treatment

     * No current treatment, often symptoms will resolve if psychiatric connection is made to patient.
     * Co-treatment of associated psychiatric syndromes

Disposition

     * Can often be discharged from ED if good support system, consider admission for psychiatric evaluation.
     * Set up close psychiatric or neurology follow up

Authors

Babak Missaghi