Re: Physical problems vs. Conversion disorder

[anonymous-user__0]

Subject: Re: Physical problems vs. Conversion disorder

Forum: The Child Behaviorial Health Forum


Dear Mommydee,
     Thank you for your inquiry.  I have to say that I'm not at all sure what can explain your daughter's complex of symptoms - but the abnormal tests would be more consistent with a physical diagnosis.  Perhaps the abnormalities indicate some kind of autoimmune disorder where the body kind of turns on itself producing many symptoms, often sparked by an unrecognized trigger.  Infection can do this, even Lyme disease or other infections.  There is a lot we don't understand about how one body can react to an insult - like an infection - but not another.  With your daughter having so many findings as well as complaints, I wonder if there is not some kind of unidentified autoimmune phenomenon. I would make sure that her thyroid functions -  as well as her other labs - are followed routinely by her primary care doctor - and that perhaps a specialist, like an immunologist, be involved. The answers may not come - but as long as she is well and controlled by her present medications, I would not hurry to make any changes.
    Your concerns are most valid - Good luck,  Dr. EV
I have been wondering about this for a while.  2 yrs ago at age 12 my daughter experienced severe abdomen pain that lasted for weeks...it progressed to joint pains, severe migraines, and finally leg weakness and a total inability to walk or even stand.  Through her hospitalization, 5 days, tests kept coming back normal.  A psychiatric evaluation was also normal.  There were no answers.  It took months of begging for referrals and evaluations to get any answers at all.  Repeat visits to the psychiatrist ended up with a diagnosis of conversion disorder, but tests that came afterward put that in doubt also.  We suddenly went from having NO explanation for her symptoms to having too many when labs started coming back!  MRI showed 2 bulging discs in her back, ANA test was positive, antidsDNA test was positive, Lyme Disease test was equivocal, one EKG was abnormal, WBC borderline low normal, one complement C4 was low, RBC were slightly low.  While getting all these tests done, child slowly improved, she missed 40 days of school and went back in a wheelchair for a few months.  Despite being SLD and missing so much school she made up all her work and ended up with all A's and B's.  She also has a six yr history of Graves' Disease.  Diagnoses has ranged from problems with the discs to lupus to Lyme Disease to depression to conversion disorder.  Like I said, from no dx to too many!  Over the last two years she has had test after test, has seen doctor after doctor (she has 8 or 9 specialists).  She is fine now with walking and after changing from competitive gymnastics to competitive swimming has rebuilt her strength and endurance, she works quite hard in school and has a 3.8 average.  She has continued problems with aches, pains, and stiffness....she continues to have positive ANA and antidsDNA, and sometimes an elevated SED.  She takes OTC ibuprofen or naprosyn as needed.  She takes nightly amitriptyline (75 mg) at night for migraine prevention.  She takes Zantac for gastritis, and Lactulose because she can't go to the bathroom without it.  She functions at a very high level.  She is however, sick of doctors.  She especially doesn't like it when docs insinuate the problem might be "in her head".  With these kinds of laboratory values, and symptoms, how likely is it that the conversion disability was an incorrect diagnosis?  (After all, when she was 8 they diagnosed ADD/H and it ended up being overactive thyroid!).  What do you think?















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