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
