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Case No. 6 - Conversion Disorder (Functional Neurological Disorder)

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Cherry Mae Torres

Ms. A, a 20-year-old salesclerk, presents to the emergency room with numbness on the left side of her face and body following an accident at a picnic. Upon examination, she reports no sensation on the entire left side of her body in a sharp delineation, though her strength and reflexes are normal. Her medical history is otherwise unremarkable, though she was previously hospitalized for an episode of transient amnesia. By the next morning, all of Ms. A's symptoms have disappeared except for a feeling of awkwardness in her left hand. She is discharged with a referral for outpatient psychiatric care.

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Case No. 6 - Conversion Disorder (Functional Neurological Disorder)

Uploaded by

Cherry Mae Torres
51 views1 page
Ms. A, a 20-year-old salesclerk, presents to the emergency room with numbness on the left side of her face and body following an accident at a picnic. Upon examination, she reports no sensation on the entire left side of her body in a sharp delineation, though her strength and reflexes are normal. Her medical history is otherwise unremarkable, though she was previously hospitalized for an episode of transient amnesia. By the next morning, all of Ms. A's symptoms have disappeared except for a feeling of awkwardness in her left hand. She is discharged with a referral for outpatient psychiatric care.

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Ms. A, a 20-year-old salesclerk, presents to the emergency room with numbness on the left side of her face and body following an accident at a picnic. Upon examination, she reports no sensation on the entire left side of her body in a sharp delineation, though her strength and reflexes are normal. Her medical history is otherwise unremarkable, though she was previously hospitalized for an episode of transient amnesia. By the next morning, all of Ms. A's symptoms have disappeared except for a feeling of awkwardness in her left hand. She is discharged with a referral for outpatient psychiatric care.

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© All Rights Reserved
Download as PDF, TXT or read online from Scribd
Download as pdf or txt
51 views1 page

Case No. 6 - Conversion Disorder (Functional Neurological Disorder)

Uploaded by

Cherry Mae Torres
Ms. A, a 20-year-old salesclerk, presents to the emergency room with numbness on the left side of her face and body following an accident at a picnic. Upon examination, she reports no sensation on the entire left side of her body in a sharp delineation, though her strength and reflexes are normal. Her medical history is otherwise unremarkable, though she was previously hospitalized for an episode of transient amnesia. By the next morning, all of Ms. A's symptoms have disappeared except for a feeling of awkwardness in her left hand. She is discharged with a referral for outpatient psychiatric care.

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Case Study No. 6 – The Case of Ms.

Ms. A, a 20-year-old single woman employed as a salesclerk, is brought to an emergency room in a large
metropolitan area by her boyfriend and several other friends. She complains of “numbness” in the left
side of her face and her left arm and shoulder subsequent to an incident at a picnic. The “numbness”
consists of having no sensation as well as “weakness” in her left arm and shoulder. Apparently, the left
side of her head accidentally struck the ground while she was being playfully carried by several friends.
Her friends report that immediately following the incident she seemed “dazed” and was inconsistently
unresponsive. Within minutes, she was fully conscious but reported the numbness and so was brought to
the emergency room.

Upon examination, Ms. A is somewhat perplexed but rather nonchalant about her symptoms. She is fully
cooperative with all examination procedures. There are no pupillary abnormalities, and her blink response
is normal. There are no signs of facial weakness. On sensory examination, she acknowledges no sensation
in any modality on the entire left side of her face, left shoulder, and left arm, with a sharp boundary
running down the middle of her forehead and neck, then angling to her axilla. She is seen to move her left
arm in conjunction with undressing, but she supports this arm in her right hand and shows weak force in
all movements involving her left arm and shoulder. Deep tendon reflexes are symmetrical and normal
strength.

Ms. A reports being in good health and denies any past or present abuse of alcohol or drugs. She describes
herself as a “shy and sensitive” person who “never feels self-confident like I should” but always has a few
good friends, nonetheless. She is a high school graduate from an outlying rural area who maintained “OK”
grades (Bs and Cs) in the “easiest classes I could take.” She especially disliked science and mathematics.
Her father worked as a clerk in a feed store and her mother as a waitress in a truck stop. She moved to
the city 2 years after graduation when her parents divorced, a breach that upset her greatly. Shortly after
relocating, she was hospitalized for a “spell” after she was found walking in a park not knowing who she
was and how, when, or why she had gotten there. Although she regained memory function soon after
admission, her recollection of the “spell” was vague. She clearly recalled her hospitalization, reporting
that after a “thorough evaluation” (which included several types of “brain wave tests”), no explanation
for the spell was given other than that she must have been “very upset.” No further evaluation or care
was recommended, but she did not return to work for several weeks “in order to recuperate.”

Ms. A had no recurrence of this or any other neurological symptoms until the present episode. She has
stayed with the same job and reports that “I enjoy the people there now that I know all of them so well.”
She has had two previous serious romantic relationships, but “they just did not work out.” Her current
relationship has lasted 8 months, but her boyfriend recently told her that “maybe we should date other
people.” She was distressed by this, especially because it reminded her of her precious breakups. After
admission to the hospital, she continues to manifest the same symptoms; however, all objective
evaluations are negative. She is advised that there does not appear to be any neurological damage and
that her symptoms should progressively improve and disappear. By the next morning, all symptoms have
disappeared except for a feeling of “awkwardness” in her left hand for which no objective cause can be
found. She is discharged with a referral for outpatient psychiatric care.

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