{"id":609,"date":"2013-01-31T16:11:38","date_gmt":"2013-01-31T16:11:38","guid":{"rendered":"https:\/\/blogs.bmj.com\/case-reports\/?p=609"},"modified":"2013-01-31T16:14:07","modified_gmt":"2013-01-31T16:14:07","slug":"stroke-mimic-an-interesting-case-of-repetitive-conversion-disorder","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/case-reports\/2013\/01\/31\/stroke-mimic-an-interesting-case-of-repetitive-conversion-disorder\/","title":{"rendered":"Stroke mimic: an interesting case of repetitive conversion disorder"},"content":{"rendered":"

Patients with non-organic or functional disorders do indeed present frequently to stroke services. The hazard for the patient is that they may receive IV thrombolysis – although limited available data.1<\/sup><\/p>\n

Chen et al<\/em> 2<\/sup> suggests as the authors here observe, that patients presenting with non-organic or functional disorders are at a relatively low risk of significant harm as a result of IV thombolysis. <\/p>\n

The other risk for patients presenting with conversion disorders or associated non-organic symptoms is that they may be subject to inappropriate investigations. However, since the consequences of missing a stroke diagnosis may be non-trivial and the diagnosis of a conversion disorder is almost always made retrospectively, it is very hard to avoid a degree of investigation that may confer harm upon the patient (whether in terms of exposure to ionizing radiation, contrast media, or discovery of incidental abnormalities). <\/p>\n

Use of the MDT can be very helpful in identifying as well as treating these patients. They respond well to occupational therapy and physiotherapy input. <\/p>\n

It is worth spending some time with the patient to explain that they have not had a stroke and that the cause of the symptoms may not be physiological. <\/p>\n

Reviewer
\nDr James Scott MRCP MSc
\nConsultant Stroke Physician<\/em><\/p>\n

References<\/u><\/p>\n

1. Winkler DT, Fluri F, Fuhr P, et al<\/em>. Thrombolysis in stroke mimics: frequency, clinical characteristics, and outcome. Stroke<\/em> 2009;40:1522\u20135. <\/p>\n

2. Chen Y, Bogosavljevic V, Leys D, et al<\/em>. Intravenous thrombolytic therapy in patients with stroke mimics: baseline characteristics and safety profile. Eur J Neurol<\/em> 2011;18:1246\u201350.<\/p>\n

Stroke mimic: an interesting case of repetitive conversion disorder<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Patients with non-organic or functional disorders do indeed present frequently to stroke services. The hazard for the patient is that they may receive IV thrombolysis – although limited available data.1 Chen et al 2 suggests as the authors here observe, that patients presenting with non-organic or functional disorders are at a relatively low risk of […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":142,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[203,2654],"tags":[],"class_list":["post-609","post","type-post","status-publish","format-standard","hentry","category-editors-choice","category-reviewers-comment"],"yoast_head":"\nStroke mimic: an interesting case of repetitive conversion disorder - BMJ Case Reports blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/case-reports\/2013\/01\/31\/stroke-mimic-an-interesting-case-of-repetitive-conversion-disorder\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Stroke mimic: an interesting case of repetitive conversion disorder - BMJ Case Reports blog\" \/>\n<meta property=\"og:description\" content=\"Patients with non-organic or functional disorders do indeed present frequently to stroke services. 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