Stroke mimicking conversion disorder: two young women who put our feet back on the ground

Abstract

We describe two young female patients with symptoms and signs initially of conversion disorder. It became apparent, however, that both patients had a posterior circulation stroke. These cases remind us of just how broad the clinical presentation of neurological diseases is and illustrate how careful we must be in our own attributions, actions and diagnoses particularly when assessing patients with bizarre behaviour and with apparent inconsistencies on neurological examination.

Patients with Acute Stroke Presenting Like Conversion Disorder

“…1 Medical literature reveals that possible intracranial pathologies can be overlooked and misdiagnosed as conversion disorder. 2,3 Although rare, some cases present to EDs with symptoms mimicking acute stroke and are diagnosed as conversion disorder. 4,5 In this article, two patients are presented who accessed the ED with an initial diagnosis of conversion disorder in the ambulance which turned out to be stroke eventually.…”

Acute stroke chameleons in a university hospital

“…2 Patients with central vestibular syndromes from cerebellar or brainstem stroke are at particular risk for misdiagnosis. 8 Other risk factors for missing a stroke may be the absence of focal neurologic deficit, young age with few cerebrovascular risk factors, and unavailability of neurologic expertise. 7 Also, emotional changes accompanying a stroke may lead to a diagnosis of psychogenic disease.…”

Bilateral Thalamic Ischemic Stroke Secondary to Occlusion of the Artery of Percheron

“…Neuropsychiatric changes like apathy and aggressiveness have been observed. There is a report of two cases in which the diagnosis was confused with conversion disorders [ 7 , 10 - 12 ].…”