Thinking about somatoform disorders, tell me how you would work up the following patient to determine that there is a conversion disorder
Mary Lou is a 38 year old female who presents to the emergency department with new onset paralysis on the left side. She presents with flaccidity of both her left arm and left leg but does not have any facial drawing. She is on othto tricyclen low, smokes 1 ppd.
•Conversion disorder is also known as functional neurological disorder.
• It is a condition in which a person is suffering from physical symptoms that seems to have no medical cause.
• Some health care providers belief that conversion is not a real condition, but the symptoms are real not imaginory and may motor functions.
• The cause of conversion disorder is unknown. But there are some risk factors that may increase the risk of functional neurological disorders-
* neurological disease such as epilepsy, migraines
* stress or physical trauma
* Any family member with functional neurologic disorder.
* history of physical or sexual abuse.
Diagnosis of conversion disorder-
• there is no test to diagnose conversion disorder because the cause is unknown.
• the physical and psychiatric examination may be used to diagnose.
* Physical examination-
√ the history regarding any psychological problem, stress or trauma is asked as the symptoms are triggered by traumatic events or stress.
√ Physical examination of patient is done to rule out the signs and symptoms and to eliminate any medical condition.
√there should not be any associated medical condition with the paralysis in this patient.
*Psychiatric examination-
√ In psychiatric examinations, questions about thoughts, feelings and behavoiur may be asked to rule out any mental health problem.
√ There is a diagnostic criteria, DSM-5 published by the American Psychiatric Association.
The DSM-5 criteria may be used to compare the symptoms.
DSM-5 lists-
.Symptoms that affect body movement or senses.
.Symptoms can not be exaplained bye a neurological or other medical or mental health condition.
.Symptoms cause significant distress or problems in social, work or other areas or they are significant enough that medical evaluation is recommended.
So now on the basis of these diagnostic criterias we can diagnose Mary Lou is having caonversion disorder.
Thinking about somatoform disorders, tell me how you would work up the following patient to determine...
Case 1 Clinic Note This 57-year-old female patient comes to the clinic today for her annual physical. HEENT: Normal LUNGS: Clear ABDOMEN: Soft, nontender RECTAL EXAM: Refused NEUROLOGICAL: Congenital spastic paralysis, left leg There are no physical findings that need to be addressed at this time. I have reviewed her care plan, and she should continue per her care plan at the residential home where she resides. ICD-10-CM Code Assignment.....x........ Case 2 Sleep Clinic Note This patient returns today following...
Case 1 Clinic Note This 57-year-old female patient comes to the clinic today for her annual physical. HEENT: Normal LUNGS: Clear ABDOMEN: Soft, nontender RECTAL EXAM: Refused NEUROLOGICAL: Congenital spastic paralysis, left leg There are no physical findings that need to be addressed at this time. I have reviewed her care plan, and she should continue per her care plan at the residential home where she resides. ICD-10-CM Code Assignment.....x........ Case 2 Sleep Clinic Note This patient returns today following...