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Postoperative Conversion Disorder Presenting as Inspiratory Stridor and Hemiparesis in a Pediatric Patient

Erik J. Nelson, Jennifer Y. Wu

(Anesthesiology, Academic Office One, University of Colorado School of Medicine, Aurora, USA)

Am J Case Rep 2017; 18:60-63

DOI: 10.12659/AJCR.901402

Published: 2017-01-17

BACKGROUND: Postoperative conversion disorder is rare and has been reported. The diagnosis is usually made after all major organic causes have been ruled out.
CASE REPORT: We describe a case of a 13-year-old female who presented in the post-anesthesia care unit with acute-onset inspiratory stridor and unresponsiveness to verbal or painful stimuli after receiving a general anesthetic for upper endoscopy. Later in the post-anesthesia care unit, she presented with acute-onset right hemiplegia and sensory loss. She was first evaluated for causes of her stridor and unresponsiveness. The evaluation revealed paradoxical vocal cord movement, and all laboratory test values were normal. For her hemiplegia and sensory loss, she was evaluated for stroke with head MRI and CT scans, which were normal.
CONCLUSIONS: After extensive workup and consideration of multiple etiologies for her presenting signs and symptoms, the most likely diagnosis was conversion disorder.

Keywords: Adolescent Psychiatry, Conversion Disorder, Postoperative Complications, Respiratory Sounds, Stroke