Jefferson Journal of Psychiatry


We present the case of an 8 year-old-girl with a 3-week history of visual conversion, inability to walk, intermittent urinary incontinence, and non-epileptic seizures. Although she had a history of shaken baby syndrome that resulted in hydrocephalus requiring bilateral ventriculoperitoneal (VP) shunt placement at 3 months of age, this current episode could not be attributed to any organic causes and hence she was diagnosed with conversion disorder with mixed presentation. In the absence of published recommendations for treatment of childhood conversion disorder, our multidisciplinary treatment team designed a biopsychosocial approach to improve her symptoms, strengthen family dynamics and provide her parents with guidance for a more stable home environment after discharge. She made substantial improvements in her ability to walk, resolution of urinary incontinence & seizure-like events, and a return to baseline personality; however, her visual conversion was not resolved. In summary, a combination of psychotropic medications, behavioral modifications and brief family psychotherapy was used in an inpatient setting for the treatment of childhood conversion disorder with mixed presentation.