Novel use of fMRI in the rehabilitation of conversion disorder

Abstract

Conversion disorder (CD) is a psychological disorder characterized by neurological symptoms, without evidence of an organic etiology. CD is more common in women, and is recognized in children and adolescents. Functional MRI (fMRI) has been shown to be useful in providing functional correlation to patients’ symptoms, and that information opens a new window of understanding. We present a case in which the objective evidence provided by fMRI led to the successful rehabilitation of an adolescent patient: A 16-year-old presented with left hemiplegia and once a diagnosis of CD was made, was admitted to the rehabilitation department. An fMRI was performed – using a block design targeting motor and somatosensory stimulation tasks to the body parts with the greatest motor and sensory loss. The results enabled the patient to understand the physiologic correlates to her symptoms and improved rapidly. Validation of the patient’s condition provided the psychological spark allowing recovery to begin.