Pediatric case study and review: is it a conversion disorder?
OBJECTIVE
It is common in health care settings for adolescent patients to report physical symptoms that are unexplained by physical disease or pathophysiologic processes. The diagnosis of conversion disorder is difficult to make as many of these patients present to primary care with complex, difficult-to-understand medical symptoms. Patients can present with a medical dilemma and a symptom model consistent with a conversion disorder, but there is a danger of misdiagnosis without a thorough medical work up.


METHODS
This case report describes a patient where the misdiagnosis of conversion disorder could have had devastating long-lasting neurologic sequelae. It appeared as if an unconscious conflict was being expressed through physical symptoms as she had ongoing family stressors prior to the onset of mysterious symptoms.


CONCLUSIONS
The patient was found to have a spinal cord arteriovenous malformation. This condition is relatively uncommon in the pediatric age group, and early diagnosis is rarely made.
Spratt
Eve G
EG
Medical University of South Carolina, Charleston 29425, USA. spratte@musc.edu
Thomas
Stephanie G
SG
D000293:Adolescent; D000437:Alcoholism / Q000175:diagnosis / Q000523:psychology; D001132:Arm; D001165:Arteriovenous Malformations / Q000175:diagnosis* / Q000523:psychology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000175:diagnosis / Q000523:psychology; D015897:Comorbidity; D003291:Conversion Disorder / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D004487:Edema / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D008279:Magnetic Resonance Imaging; D002189:Marijuana Abuse / Q000175:diagnosis / Q000523:psychology; D010291:Paresis / Q000175:diagnosis / Q000523:psychology*; D010348:Patient Care Team; D013116:Spinal Cord / Q000098:blood supply*; D014029:Tobacco Use Disorder / Q000175:diagnosis / Q000523:psychology