Conversion disorder: Difference between revisions
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==Background== | ==Background== | ||
* One or more symptoms that involve motor or sensory neurologic function believed to be related to a psychiatric condition.<ref>Allin M, Streeruwitz A, Curtis V. Progress in understanding conversion disorder. Neuropsychiatr Dis Treat. Sep 2005;1(3):205-9</ref> | *One or more symptoms that involve motor or sensory neurologic function believed to be related to a psychiatric condition.<ref>Allin M, Streeruwitz A, Curtis V. Progress in understanding conversion disorder. Neuropsychiatr Dis Treat. Sep 2005;1(3):205-9</ref> | ||
* The symptoms are not intentionally produced | *The symptoms are not intentionally produced | ||
* '''Diagnosis of exclusion''' | *'''Diagnosis of exclusion''' | ||
* Often associated with patient who is unconcerned or neutral to the loss of motor/sensory function | *Often associated with patient who is unconcerned or neutral to the loss of motor/sensory function | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
* Malingering | *Malingering | ||
* [[Hypokalemic_periodic_paralysis|Hypokalemic Periodic Paralysis]] | *[[Hypokalemic_periodic_paralysis|Hypokalemic Periodic Paralysis]] | ||
* [[Multiple_Sclerosis|Multiple Sclerosis]] | *[[Multiple_Sclerosis|Multiple Sclerosis]] | ||
* [[Myasthenia_Gravis|Myasthenia Gravis]] | *[[Myasthenia_Gravis|Myasthenia Gravis]] | ||
* [[CVA|Stroke]] | *[[CVA|Stroke]] | ||
* [[Guillain-Barre_Syndrome|Guillain-Barre Syndrome]] | *[[Guillain-Barre_Syndrome|Guillain-Barre Syndrome]] | ||
* Spinal Impingement/Epidural Abscess | *Spinal Impingement/Epidural Abscess | ||
{{Psych DDX}} | {{Psych DDX}} | ||
==Diagnostic Studies== | ==Diagnostic Studies== | ||
* All test will be negative: should consider CT, CBC, CHEM 10, LP, Possible MRI if concerned for spinal pathology | *All test will be negative: should consider CT, CBC, CHEM 10, LP, Possible MRI if concerned for spinal pathology | ||
*See here for [https://www.youtube.com/watch?v=CG5n516PCXM Optokinetic drum] | *See here for [https://www.youtube.com/watch?v=CG5n516PCXM Optokinetic drum] | ||
==Treatment== | ==Treatment== | ||
* No current treatment, often symptoms will resolve if psychiatric connection is made to patient | *No current treatment, often symptoms will resolve if psychiatric connection is made to patient | ||
* Co-treatment of associated psychiatric syndromes | *Co-treatment of associated psychiatric syndromes | ||
==Disposition== | ==Disposition== | ||
* Can often be discharged from ED if good support system, consider admission for psychiatric evaluation. | *Can often be discharged from ED if good support system, consider admission for psychiatric evaluation. | ||
* Set up close psychiatric or neurology follow up | *Set up close psychiatric or neurology follow up | ||
==References== | ==References== | ||
Revision as of 15:25, 4 July 2016
Background
- One or more symptoms that involve motor or sensory neurologic function believed to be related to a psychiatric condition.[1]
- 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
General Psychiatric
- Organic causes
- Psychiatric causes
Diagnostic Studies
- All test will be negative: should consider CT, CBC, CHEM 10, LP, Possible MRI if concerned for spinal pathology
- See here for Optokinetic drum
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
References
- ↑ Allin M, Streeruwitz A, Curtis V. Progress in understanding conversion disorder. Neuropsychiatr Dis Treat. Sep 2005;1(3):205-9