Conversion Disorder; an Unusual Etiology of Unilateral Foot Drop

Foot drop is generally a consequence of common peroneal or sciatic nerve injury or L5 radiculopathy but rarely, it can be a manifestation of conversion disorder.

A 24-year-old male presented with a foot drop on left side that developed overnight. He had difficulty walking with a trunk tilt towards right side and numbness in left leg up to mid-thigh. The initial diagnosis by the general practitioner was common peroneal nerve injury, which was not supported by the subsequent detailed examination in the physiatry department. Routine laboratory investigations, computed tomographic scan of brain and electrophysiological evaluation were normal. In a multidisciplinary team evaluation involving a psychiatrist, he was diagnosed to be suffering from conversion disorder and was advised gait retraining, cognitive and behavioral therapy and tablet venlafaxine. By sixth day of treatment, the patient was able to walk independently with a normal gait pattern and reported complete recovery of his symptoms.

In the absence of an identifiable organic cause of foot drop in a patient, conversion disorder may be considered necessitating early intervention by a psychiatrist.