Postoperative hemiparesis due to conversion disorder after moderate sedation: a case report

Peri-operative conversion disorder that manifests as postoperative muscle weakness is an uncommon diagnosis made through exclusion of neurological, metabolic or iatrogenic aetiologies. We present a case where a patient with a considerable history of physical and psychological trauma suffered from prolonged right-sided hemiparesis following a breast biopsy under moderate-to-deep sedation. Conversion disorder following moderate-to-deep sedation has yet to be discussed in the literature, as all previous cases have described postoperative conversion disorder in the setting of general or central neuraxial anaesthesia. Our recommendation is for practitioners to keep conversion disorder on the list of differential diagnoses, despite the depth of sedation or type of anaesthetic utilised, and perform the same detailed neurological, metabolic and psychiatric assessment when considering postoperative weakness.