Re: Physical problems vs. Conversion disorder

[anonymous-user__0]

Subject: Re: Physical problems vs. Conversion disorder

Forum: The Child Behaviorial Health Forum


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?





Dear mommydee,
The accumulated evidence indicates that your daughter's difficulties were medically, not psychologically, driven. At the outset, particularly with negative medical workups (including labs), the conversion disorder diagnosis was understandable. However, it appears to have been effectively ruled out by subsequent diagnostic procedures.
As you probably already know, one criterion of conversion disorder requires that the symptom(s) cannot be fully explained by a general medical condition. The range of findings that ultimately were derived certainly do explain your daughter's difficulties. Another criterion of conversion disorder (which is one of several types of so-called somatoform disorders) is that initiation or exacerbation of the symptom(s) is preceded by conflicts or other stressors. Your note does not indicate that such 'explanatory' variables were present with your daughter.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options that pertain to your medical situation/condition.
*Keyword: conversion disorder









Follow Ups:


Physical problems vs. Conversion disorder mommydee 3/03/1999
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Re: Physical problems vs. Conversion disorder HVM Ph. D. - KDK 3/06/1999
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