Abstract
Conversion disorder, also referred to as functional neurological symptom disorder, is a DSM-5 identified somatic disorder that presents with one or more neurological symptoms that does not clinically correlate with recognized neurological or medical conditions brought on by intense stress, emotions, or an associated psychiatric disorder. Multiple sclerosis (MS) is the most common immune-mediated inflammatory demyelinating disease of the central nervous system and usually presents in young adults with clinical manifestations that range from cognitive abnormalities, eye movement problems, motor and sensory impairments such as weakness and numbness, bowel/bladder dysfunction, fatigue, and/or pain. This case report presents a patient with functional neurological symptom disorder presenting with clinical signs associated with MS.
Highlights
Conversion disorder, known as functional neurological symptom disorder (FNSD), is a somatic disorder caused by severe stress, emotional conflict, or an associated psychiatric disorder usually presenting with one or more neurologic symptoms [1]
Multiple sclerosis (MS), an immunemediated inflammatory disease, is the most common demyelinating disease of the central nervous system (CNS) which often presents in a young adult with a clinically isolated syndrome such as optic neuritis, long tract symptoms/signs, a brainstem syndrome, or a spinal cord syndrome [9]
Multiple sclerosis typically presents in a young adult with a clinically isolated syndrome such as optic neuritis, long tract symptoms/signs, a brainstem syndrome, or a spinal cord syndrome
Summary
Conversion disorder, known as functional neurological symptom disorder (FNSD), is a somatic disorder caused by severe stress, emotional conflict, or an associated psychiatric disorder usually presenting with one or more neurologic symptoms [1]. The authors report a patient that presented with common clinical signs and symptoms of MS but lacked clinical evidence to confirm the diagnosis and conversion disorder was diagnosed. Waveforms obtained from the observed conduction studies and F wave latencies were within normal limits except the borderline right and left median motor distal latencies which were concerning for mild, bilateral carpal tunnel syndromes but otherwise showed no consistent findings of MS (Figure 1). All waveforms are within normal limits with the exception of the borderline right and left median motor distal latencies are suspicious for mild, bilateral carpal tunnel syndromes. Three-month follow-up showed that the patient had passed the initially failed class, was continuing a healthy lifestyle with exercise, had entered a new relationship, and no longer complained of any symptoms and/or reported any recurrences
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