Lower extremity paralysis in a male preadolescent

A 12-year-old boy presented to the emergency department with bilateral lower leg sensory loss and inability to walk. The initial work-up revealed no significant abnormalities on physical examination other than bilateral paralysis and no laboratory abnormalities. The inpatient work-up included neurologic, psychiatric, and psycho-logic evaluations. The patient was diagnosed with a conversion disorder, and treatment included relaxation exercises and guided imagery as well as antidepressants. Upon discharge, the patient was walking without assistance. Follow-up therapy was initiated for stress and behavior management. No further episodes have occurred. Diagnosis, therapy options, and outcomes of conversion disorder are further discussed as they relate to treatment by general pediatricians.