A 37-year-old woman comes to the emergency depament with sudden onset of left leg weakness. There is no history of any prior medical illness. On neurological examination, there is no wasting, muscle tone is normal, deep-tendon reflexes are normal, and plantars show 'flexor' response. The patient cannot raise her left leg off the bed while supine and is very worried that something is wrong. MRI brain does not reveal any abnormality. Which of the following is the most likely diagnosis?
This patient had a sudden onset of neurological symptoms , and the symptoms and clinical examination findings are inconsistent. This is a strong pointer towards conversion disorder. Please note that there is no la belle indifference (lack of concern for the symptoms) in this patient. La belle indifference is not seen in all patients with conversion disorder. In contrast to conversion disorders, patient with factitious disorders voluntarily produce the symptoms and the question gives a hint about it.
Conversion disorder
Factitious disorder
Illness anxiety disorder
Malingering
Neurotic, Stress Related and Somatoform Disorders