Psychiatry and Clinical Psychopharmacology

A case of conversion disorder, which was followed as multiple sclerosis

Psychiatry and Clinical Psychopharmacology 2014; 24: Supplement S296-S296
Read: 812 Published: 17 February 2021

E.S, 33 years old, female, married with 3 children, house wife. Chief complaints: falling down while walking, weakness in the lower extremities. 1 week before her last admission to Erenkoy Hospital Neurology inpatient department, she fell down in the street. In the following days, symptoms such as weakness in her left extremities, pain in her right half of the body, double vision and difficulty in standing up were appeared. Her complaint had first begun in 2003, as falling down and weakness in her left body half. Her symptoms ceased spontaneously without any treatment. In year 2006, numbness in her right body half, double vision, difficulty in swallowing, nausea, loss of balance were emerged. She was admitted to a hospital. Her MRI revealed non-specific abnormalities in white matter. Her symptoms were thought to be psychiatric, and she was given olanzapine 2.5 mg/day, diphenylhydantoin 200 mg/day. In year 2009, she was admitted to inpatient department with similar complaints as well as generalized body pain. Multiple Sclerosis was preliminary diagnosis and she was given steroids for 10 days. In year 2010, she was admitted to hospital again with numbness in left side of her face, double vision and difficulty in walking. Her diagnosis was somatization disorder and multiple sclerosis. She was given steroid for 10 days and then Interferon Beta 1a 100 mg weekly. Her symptoms repeated in 2013 in spite of the treatment. In her neurological examination, hypoesthesia and pain in her left body half and ataxic gait towards her left was detected. Her laboratory findings were within normal limits, her CSF examination was normal. Oligoclonal band and IgG index were within normal limits. Her MRI did not reveal any abnormality. Her EMG was normal. Her diagnosis was somatization disorder. She was not given any drug treatment, but was consulted to psychotherapy center for further evaluation. In her psychiatric evaluation, it was understood that her symptoms were first started when she was pregnant to her first child in year 1999. Then her symptoms were repeated, in her second and third pregnancy in years 2003 and 2005. During the pregnancies and after the deliveries, her symptoms were aggravated. She was the fourth of 10 children. Her father died in year 1998. Her mother could not deal with her enough when she was a child. Mostly her elder sister took care of her. She was married when she was 17. Her sister was living together with her mother-in-law for the last 15 years. Her diagnosis was thought to be conversion disorder. At the end of the fourth interview, most of her symptoms were disappeared.

EISSN 2475-0581