Postoperative conversion disorder in a pediatric patient.
According to the Diagnostic and Statistical Manual IV (DSM IV), conversion disorder is classified as a somatoform illness and defined as an alteration or loss of physical function because of the expression of an underlying psychological ailment. This condition, previously known as hysteria, hysterical neurosis, or conversion hysteria occurs rarely, with an incidence of 11-300 cases per 100,000 people (American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th edn. Washington, DC: American Psychiatric Association, 1994). Presentation after an anesthetic is exceptional. After thorough review of the literature, fewer than 20 cases have been documented, with only two instances in patients younger than 18 years of age after general anesthesia; both were mild in nature. We present a severe case of postoperative conversion disorder that developed upon emergence from anesthesia in a previously healthy 16-year-old girl following direct laryngoscopy with vocal fold injection.
Judge
Amy
A
Department of Anesthesiology, University of North Carolina, Chapel Hill, NC 27599-7010, USA. amy.judge@yahoo.com
Spielman
Fred
F
D000293:Adolescent; D000762:Anesthesia Recovery Period; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D003291:Conversion Disorder / Q000209:etiology* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D018908:Muscle Weakness / Q000209:etiology / Q000523:psychology; D010243:Paralysis / Q000209:etiology / Q000523:psychology; D011183:Postoperative Complications / Q000209:etiology* / Q000523:psychology; D014826:Vocal Cord Paralysis / Q000150:complications / Q000601:surgery