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Discussion

Conversion Syndrome

There was a pt in clinical today and the primary nurse told us she had conversion syndrome. I looked up as much as I could on the net but didn't find very much. She presented as a CVA with right sided weakness - yesterday she says she can't move her right arm/leg but was able to get the the bedside toilet. Today she still can't move her right extremities but now cannot speak. CT's and labs are all normal. How is this treated? Is it diagnosed by exclusion and history? This was very interesting to us and I hope I'm not bothering anyone by posting here. Thanks in advance.

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There was a pt in clinical today and the primary nurse told us she had conversion syndrome. I looked up as much as I could on the net but didn't find very much. She presented as a CVA with right sided weakness - yesterday she says she can't move her right arm/leg but was able to get the the bedside toilet. Today she still can't move her right extremities but now cannot speak. CT's and labs are all normal. How is this treated? Is it diagnosed by exclusion and history? This was very interesting to us and I hope I'm not bothering anyone by posting here. Thanks in advance.

Physical loss of functions in the absence of physiological rationale. Another term is hysterical neurosis.

This is not seen so often in our more medically sophistcated society but was quite common during WW I. Soldiers would find that they could not walk because of a paralysis of their legs. These were brave men, not cowards. They would not consciously refuse to go back into battle. But trench warfare was a meat grinder. It was not sane to go back to it once you got out alive and not acceptable for a healthy soldier to refuse. How could he call himself a man? But a fellow can't help it if he's sick.

I have seen only a couple cases. They overlap with malingerers. The difference is the conscious awareness of the "faking". Malingerers know what they are doing.

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Very interesting. Thanks for your replies.

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