CONVERSION DISORDER PRESENTING IN A PATIENT WITH AN IMPLANTABLE MORPHINE PUMP AND AN EPIDURAL ABSCESS RESULTING IN PARAPLEGIA

Conversion disorders are symptoms or deficits affecting voluntary moto r or sensory function that suggest a neurological or medical condition . The psychological symptoms associated with the medical condition mus t be preceded by conflict or other stressors. We present an individual who developed conversion disorder and paraplegia secondary to a steri le epidural abscess near the tip of her surgically implanted, epidural morphine infusion pump. She manifested at varying times both transien t bilateral blindness and pseudoseizures consistent with a diagnosis o f conversion disorder. Neurological evaluation for seizure activity an d meningitis were negative. The etiology of the sterile epidural absce ss remained unknown. The essential features of conversion disorder, ac cording to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, are discussed. Treatment of patients diagnosed with co nversion disorder remains primarily supportive, with the focus on cons istency and behavioral management. Extreme caution is suggested in reg ards to further investigations. (C) 1997 by the American Congress of R ehabilitation Medicine and the American Academy of Physical Medicine a nd Rehabilitation.