Conversion Disorder and the Complete Resolution of a Spastic Equinovarus Deformity with Conservative Treatment

Abstract Conversion disorder is a complex ailment resulting in a myriad of voluntary motor or sensory symptoms ranging from tremors, headaches, paralysis, aphasia, and visual impairments. Though the motor and/or sensory symptoms have been associated with an underlying psychological stressor in the past, recent criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) focuses on the lack of a neurological, medical or mental cause. This report describes a case of an acute spastic equinovarus and associated sensation loss in the entire left lower extremity of a young, healthy female without an organic cause. The patient underwent conservative care in the form of physical therapy and, with various modalities including dry needling and electrical stimulation, she was able to return to full function without the need for an assistive device or bracing. One must examine the entire gestalt of a patient with this disorder as opposed to the limited, initial physical presentation. Laboratory and diagnostic exams will frequently return within normal limits, perplexing the initial physician. However, with repeated reassurance and education of the patient, along with an interdisciplinary approach, a patient may return to full activity while avoiding the operating suite.