Clinical presentation of conversion disorder in pediatric emergency service: three case reports

Abstract

Conversion disorders in adolescents can have dramatic clinical presentation which may be diffi cult to distinguish from organic or other psychiatric disorders. We describe three female adolescents aged 11 to 13 years, brought to the pediatric emergency room with psychogenic nonepileptic fi ts. Due to the dramatic clinical presentation, unresponsiveness and similarity to true epileptic seizures, they were initially thought to need resuscitation and anticonvulsant therapy, and were hospitalized. The work-up could not disclose any organic origin of their symptoms. Psychological testing and consultation with the child and adolescent psychiatrist led to the diagnosis of conversion disorder and further treatment and follow up was scheduled at the child and adolescent psychiatry department. In order to avoid confusion and unnecessary and potentially risky therapeutic interventions, it is crucial to consider the possibility of psychogenic nonepileptic seizures in everyday pediatric emergency practice.