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