Conversion Disorder or Oversite by Nuerologist

[lsbll]

I am writing concerning my fifteen year old daughter.  She is a great kid, high acheiver, sophmore, loves life and learning.  She became ill in October of this year with flu like symtoms, sore throat, dizziness, low grade fever and weakness being her chief complaints.  Over a period of a couple of months she continued to get weaker and dizzier. She also missed a bit of school, although she would attempt to go.  Her primary care doctor sent her to a Rhuematologist, who diagnosed Fibromyalgia.  Finally we thought we had the answer to what was causing her weakness and dizziness.  We decided to fight this illness, and she tried with all her might to do the excersises the doctor ordered.  She also was back in school about two hours a day.  This would completly wipe her out.  She continued to get so dizzy that she used a cane to get around.  Her Rhuematologist who she saw only three times, became concerned about her gait and sent her for a CT Scan and MRI.  They found a possible infection or inflammation of the Petrous Apex.  She was then sent to a neurologist who admitted her to the hospital so a ENT could see her right away.  He came and talked to her then had her walk for him, at which time she attempted to, as she was falling backwards she grabbed her pants.  He immediatly called me out of her room and said a dizzy person could not possibly grab her pants when falling.  I had asked him if he had looked at the MRI yet and he said not yet but he doubted that it would show him anything.  They also took an MRI of her spin and found a Syrinx.  The ENT and Neurologist conferred and told me that what she had was Conversion Disorder, that she wasn't really sick but that she thought she was. The ENT also ordered a ENG test to show if she was truly dizzy.  The ENG came back showing she was dizzy and showing vertical nystagmus, and left beating nystagmus, indicative of a central involvement.  We are a military family and had the test done at a different hospital then where this doctor was.  When we gave him the results, he wanted the test redone so it would show a negative result, his words.  I left his office at that time and I'm attempting to get different medical help.
A couple of months before being admitted to the hospital I took her to a psychologist so he could help her learn coping skills for Fibromyalgia.  They talked for a while and he found her to be a strong kid that was trying to adapt and over come this illness.  We did not feel the need to continue theropy.  In the hospital she saw a Pshyciatrist who did an in depth interview with her.  He told us that she was a wonderful young lady, with no signs of any depression or any other pertanint psychiatric condition and to seek medical help.  After her stay she met with a psychotheripist that was highly recommended.  After his visits with her he could find no evidence of Conversion Disorder.  He said she was angry at the doctors for trying to write her off, but other then that he felt she had a medical problem.
We are currently trying to get compitant medical help for her.  My question is can Conversion Disorder present in this way?  She had a gradual onset of symptoms,  no horrible trauma and she is not prone to do something negative to acheive something.  I have no aversion to mental health issues, if that is truly what is wrong with her.  Am I right to continue to seek medical help?  Thank you for your time.

[Roger Gould, M.D.]

It sounds like you are right to seek a proper medical diagnosis,especially since competent mental health people have already examined her and dispelled the diagnosis of conversion reaction.

It is very unlikely that she has a conversion reaction. It is only a remote possibility. Sometimes they come on after an illness in ways like this, but you should be thinking medical first.

[s.k]

hmmm circumstantial much? Not certain even where this logic is comming from. Perhaps has to do with the diagnosis he was ruling out?

[lord_mike]

That is rediculous!  The ENT should have his license revoked.  If he wasn't such an idiot, he would know that vertical nystygmus is ALWAYS a brainstem problem and it can't be faked or reproduced psychologically.

I would recommend seeng a neurologist balance specialits not an ENT balance specialist.  ENT's only recognize spinning vertigo as dizziness, and can't thing of anything else.   Their surgeons not internests, and if they can't cut away at something, they are baffled.  The arrogance of his ignorance!

PLease post your problem at the neurology forum.  There you will get a competant neurological opinion instead of your quack ENT.

[wildcat]

From what I have read and observed while on in-patient treatment for alcoholism in the past, is that most people with conversion disorders have what are called pseudo-seizures. The kind that are whacky wayout in left field trying to call attention to everyone around them by flailing all over the place, banging their heads on the floor or wall over and over and so on.

Her condition sounds like a real physical disorder not a conversion or somatic disorder.

[bootsycat]

Okay, so today I present at ER for worsening symptoms of undiagnosed syndrome.  Had been trying to rule out MS and as I began to educate myself, found fibromyalsia (fibromyalgia) to fit so perfectly.  No doctor had ever even mentioned it to me, even though my symptoms were very obvious.  I understand why we must rule out other degenerative criteria but leaving me in the dark won't help either.  So I'm already upset, right? and can't get in to see the neurologist who was doing all this "ruling out".  I told the nurse I was thinking fibromyalsia (fibromyalgia), she said just wait until end of November.  We'll discuss it then.  Middle of the night came and symptoms were so bad, I had to get some answers.  Call head nurse, asked to come in to ER.  Presented. Diagnosed with Conversion Disorder.  They had absolutely no evidence to support the diagnosis.  No one did that with MS!  And they certainly won't even consider Fibromyalsia (fibromyalgia).  I drew their attention to it and they said they didn't even know what I was talking about.  Oh come on.  I was at a state health facility on state insurance.  I have been unable to work for 6 months on any regular basis.  I get the distinct impression it is politically incorrect in dealing with state insured patients to even entertain the idea of any kind of disability.  No.  It must all be in my head.  Right.