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Conversion Disorder Masquerading as Severe Progressive Neurological Deterioration in Childhood

Published online by Cambridge University Press:  01 February 1999

Clare B. Nourse
Affiliation:
8 Pambula Street, The Gap, QLD 4061, Australia. Previously Department of Paediatrics, University College Dublin, Our Lady's Hospital for Sick Children, Crumlin, Dublin 12, Ireland
Imelda Ryan
Affiliation:
Our Lady's Hospital for Sick Children, Crumlin, Dublin 12, Ireland
Joe McMenamin
Affiliation:
Department of Paediatrics, Royal College of Surgeons in Ireland and Our Lady's Hospital for Sick Children, Crumlin, Dublin 12, Ireland
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Abstract

Diagnosis of neurological conversion disorder is difficult. Considerable overlap in symptomatology occurs with progressive neurological degenerative disease, pervasive refusal syndrome, depressive illness, chronic fatigue syndrome, and other conditions. Conversion symptoms can also coincide with organic neurological disease. Successful management requires a sensitive, confident, multidisciplinary approach. Multiple or repeated investigations can be counterproductive in resolving symptoms. This report describes three children, one male and two female, aged between 9 and 10 years, who were referred for evaluation of progressive neurological symptoms. Each progressed to a completely dependent state within 8 weeks of referral, requiring nasogastric feeding and total assisted care. A convincing psychosocial trigger was not identified in any case. Improvement occurred only when investigations were ceased and rehabilitation commenced. Long-term follow-up has revealed an excellent outcome for all three children.

Type
Original Article
Copyright
© 1999 Association for Child Psychology and Psychiatry

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