Research Day

A Curious Case Of Conversion Disorder

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INTRODUCTION: Conversion disorder is a functional neurologic symptom disorder, in which there is no neurological etiology, and the symptoms cause impairment or distress (1). About 90% of these patients have a psychiatric comorbidity (2,3,4).

PURPOSE: We present an unusual case of Conversion Disorder in a healthy young male with psychological conflict caused by past events in light of recent life changes.

MATERIALS AND METHODS: Case report information was obtained from patient's chart review, the patient gave consent for presentation of information.

CASE REPORT: A 21 yo male was admitted to the hospital with altered mental status after a reported overdose on Xanax and Adderall. UDS was negative, non-contrast head CT showed no acute changes, and basic labs were within normal limits.

Patient continued to have neurological symptoms, including mutism, shaking, disregarding commands, drooling, and incontinence of urine and stool. EEG and MRI showed no abnormalities. Neurology and psychiatry suggested some component of conversion disorder and possible regression. With supportive care patient recovered enough to admit to a history of depression and anxiety, exacerbated by current life events.

DISCUSSION/CONCLUSION: Symptoms of Conversion Disorder included nonepileptic seizures, weakness, paralysis, movement disorders, speech disturbances, globus sensation, sensory complaints, visual symptoms, and cognitive symptoms, which can be chronic or acute, constant, or intermittent (1,2). This patient's presentation was unusual as there was a component of regression, in the form incontinence, mutism, and refusal to follow commands. Here, we highlight the importance of recognizing conversion disorder and regression and treatment of underlying psychiatric illness.

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