Conversion disorder presenting as multiple sclerosis

Area of Science:

• Neurology
• Psychiatry

Background:

• Multiple sclerosis (MS) is a chronic neurological disorder affecting the central nervous system.
• Accurate diagnosis of MS relies on clinical presentation, imaging, and laboratory tests.
• Conversion disorder can mimic neurological conditions, posing diagnostic challenges.

Observation:

• A patient presented with symptoms suggestive of clinically definite multiple sclerosis.
• Subsequent evaluation revealed fictitious examination findings.
• Radiological, electrophysiological, and biochemical tests were all normal.
• Symptoms resolved following sodium pentothal administration and hypnosis.

Findings:

• The patient's presentation was inconsistent with multiple sclerosis.
• The diagnostic workup ruled out organic neurological disease.
• The patient's condition was reclassified as conversion disorder.
• Symptom reversal was achieved through psychotherapeutic interventions.

Implications:

• This case underscores the importance of a comprehensive diagnostic approach in neurology.
• It highlights the potential for conversion disorder to mimic serious neurological conditions like MS.
• The successful use of sodium pentothal and hypnosis suggests the efficacy of psychogenic treatment modalities.