[Epidural anesthesia in labor and conversion disorder]

A 37-year-old woman came to our hospital at the beginning of labor. She reported a history of depression with attempted suicide some years earlier and had also undergone dilation and curettage following an abortion; on admission to our hospital, she was euthymic and not receiving treatment. The patient requested epidural analgesia. Several hours later, she reported dorsal foot numbness and difficulty performing dorsal flexion. After an organic cause had been ruled out, a diagnosis of conversion disorder was considered. The incidence of this psychiatric disorder is high, though it is usually underdiagnosed. Conversion disorder involves at least 1 neurologic symptom suggestive of organic disease. Symptoms are not feigned and cannot be ascribed to a medical disease, the effects of a toxic substance, or culturally normal behavior, yet there is significant clinical, social, and occupational deterioration.