轉化症下肢癱瘓：病例報告

A 21-year-old man had progressive weakness and numbness of bilateral lower extremities and sphincter dysfunction after a traffic accident. The image and electrodiagnostic study showed no significant abnormal findings. Conversion paraplegia was suspected due to unusual clinical presentation, which cannot be explained by neuropathologic lesions. After intensive rehabilitation, patient's functional performance improved significantly and he could walk independently without device. But later, a fibrous dysplasia lesion was found at left sphenoid greater wing. He received an operation to remove it. The relationship between his benign brain tumor and conversion disorder is unknown, but the tumor that compressed temporal lobe might be associated with conversion disorder.
Conversion disorder is a psychogenic motor or sensory deficit, with prevalence of about 5-10/100,000. It occurs mainly in young patients, affecting female 4 times than male. The mechanism of conversion disorder is unknown. The diagnosis was established mainly by excluding other causes. Diagnosis of conversion disorder depends on some special clinical signs, such as la belle indifference and unstable neurological deficits. Multidisciplinary treatment for conversion disorder is recommended and intensive rehabilitation is needed for those whose functional status is compromised. The general prognosis of conversion disorder is good.