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Testing Sensory and Multisensory Function in Children with Autism Spectrum Disorder
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Upper extremity conversion disorder in children.

Rajan R Murgai1, Curtis VandenBerg1, Milan Stevanovic2

  • 1Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, CA, USA.

Journal of Shoulder and Elbow Surgery
|January 28, 2019
PubMed
Summary
This summary is machine-generated.

Conversion disorder in children can mimic orthopedic issues, leading to extensive testing. Early recognition and examination under anesthesia aid diagnosis and management of this rare condition.

Keywords:
Conversion disorderadolescentchildrenexamination under anesthesiafunctional neurologic disorderhysterical paralysispediatricpsychiatric illness

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Area of Science:

  • Pediatric Orthopedics
  • Child and Adolescent Psychiatry
  • Functional Neurological Disorders

Background:

  • Conversion disorder in the upper extremity poses diagnostic challenges for orthopedic surgeons.
  • It often leads to extensive, costly, and unnecessary investigations and treatments.
  • This study aims to increase awareness and guide diagnosis/management of this uncommon condition in children.

Observation:

  • Four pediatric patients presented with upper extremity symptoms including muscle stiffness, spasms, pain, and limited motion.
  • Patients underwent extensive prior evaluations by multiple specialists with inconclusive results.
  • Psychiatric history was noted in two patients; all exhibited signs of depression and despair.

Findings:

  • Physical examination under anesthesia revealed normal findings in all patients.
  • Two patients treated with botulinum toxin injections showed improvement in shoulder range of motion.
  • The average cost of care per patient was $42,729.

Implications:

  • Consider conversion disorder in pediatric patients with unexplained deficits inconsistent with imaging and a psychiatric history.
  • Examination under anesthesia is a valuable diagnostic tool for suspected pediatric conversion disorder.
  • Accurate diagnosis can prevent unnecessary medical interventions and reduce healthcare costs.